Diversification of care policy measures supporting older people: towards greater flexibility for carers?

Abstract

Originally part of the private domain of families, care of the older people is now the concern of public policy. Yet, in the European context of cost containment, it is not easy to make a case for increasing public support and the caring function of families remains prominent in social policy. In this paper, the authors question public policies around care of the older people in relation to both the needs of old people, but also those of adult children, mainly women, who work and provide care for their old parents. We investigate the interactions between public support in long-term care and the caring function of families. The paper presents some results of a comparative research study based on the identification of the policy measures which have been implemented in different European countries in the sector of care of the older people, and on the detailed analysis of care arrangements set up by a sample of 86 family carers in these various national contexts. We argue that in a context of cost containment, whatever the usual patterns of care and the role given to the family and public authorities, the policy measures which have been introduced since the 90s aim to support family carers in various ways with the common objective of giving them the flexibility they need in the organisation of care arrangements, combining various resources (formal professional care, unpaid informal care, semi-formal care). Different patterns of flexibility can be identified according to the regulation of the policy measures.

Analyses of welfare-state reform policies towards long-term senior care in a cross-European perspective

“…The care policies of the Dutch welfare state are relatively generous, and the state has a main role in the regulation of cash payments, care leave and flexibility of working hours. In Italy, by contrast, the welfare state has a fairly minor role in long-term senior care, and care policies are not generous (Le Bihan and Martin 2012). As the authors show, welfare states also support such practices indirectly when they offer cash-for-care but with only low-level monitoring of the schemes by public authorities.…”

“…Le Bihan and Martin found that in the Netherlands, care work is mainly formal employment, whereas in Italy the organisation of care relies strongly on undeclared employment of mostly female, migrant care workers in private households (Le Bihan and Martin 2012). According to the authors, differences in the generosity of states' senior-care policies are the main factor which explains such differences.…”

“…Welfare states have also started to support family members more in their caring role. The unpaid, informal care done by (mostly female) spouses or adult children of the frail older adults has been substantially transformed into forms of family care paid by state programmes such as 'cash-for-care', or by municipalities (Le Bihan and Martin 2012;Ungerson and Yeandle 2006). This can be termed a 'semi-formalisation' of care, since pay and formal agreements have in part entered informal care work (Geissler and Pfau-Effinger 2005).…”

Development and Difficulties of the Eldercare System in Croatia

“…Ovisnost u starijoj dobi prepoznaje se kao socijalni rizik tek unatrag dva desetljeća, kada počinje intenzivnije razmatranje i provođenje reformi koje vode formaliziranju skrbi, odnosno raste javna uključenost u reguliranje, financiranje, organiziranje i pružanje skrbi starijima (Rostgaard i Zechner, 2012). Veća uloga države ogleda se u sve većem obuhvatu uslugama dugotrajne skrbi, prepoznavanju prava na skrb kao socijalnoga prava, uvođenju osiguranja za dugotrajnu skrb i/ili u priznavanju neformalne skrbi (vidi Schut i Van den Berg, 2010;Rostgaard i Zechner, 2012;Le Bihan i Martin, 2012;Ranci i Pavolini, 2013). 1 Priznavanje neformalne skrbi vodi tzv.…”

“…Posebice raste popularnost shema kojima se osigurava naknada za skrb (eng. cash-for-care; da Roit, Le Bihan i Österle, 2007;da Roit, 2012;Le Bihan i Martin, 2012), ali i dopusti mogućnost prilagodbe radnoga vremena zbog pružanja dugotrajne skrbi (Le Bihan i Martin, 2012). Poluformalizacija skrbi čini granice između uobičajenih oblika skrbi, formalnih i neformalnih, plaćenih i neplaćenih, nejasnima (Pfau-Effinger i Geissler, 2005), dok u nekim zemljama (npr.…”