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RPS 1 2018

Il testo è la sintesi dell’articolo pubblicato nella sezione Tema del n. 1 2018 di Rps e scaricabile dagli abbonati nella versione integrale al link:

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The Reform of Long-Term Care in Austria: A New Pillar of the Welfare State Emerges and Develops

Articolo scritto da:

The paper defines the broader context of reforms in long term care in Austria in the last two decades. The essay focuses on the 1993 «cash for care» reform, looking at the content of the reform, at the concrete mechanisms that have allowed institutional change, and at the coalitions of actors who have pushed for change. In recent years a new major reform has been introduced, focusing exclusively on the regularization of personal care in the private household without touching upon the broader Ltc context: the last part of the paper describes this innovation by considering the drivers of the growing migrant care market, the mechanisms that have allowed institutional change, and the role of government, media, and disability movement in this change.only subscribers can see the full article
Keywords: Europe :: elderly care :: Long-term Care :: Aging :: Austria ::

Policies for Long-Term Care in Spain: A Hybrid System of Family Care and Institutionalized Risk

In 2006 Spain introduced a new public long-term care programme regarding the Promotion of Personal Autonomy and Care for Dependent Persons. The paper develops an analysis of the main social and political factors and mechanisms driving this importantreform. The factors of innovation are identified, by considering cultural changes related to responsibility for care, new facts emerging in the organisation and provision of are, the policy legacy factors. In the second part the institutional mechanism of decision making and implementation is described and the new model of Ltc provision that have been established in Spain is described, focusing on the extension of coverage, the intensity of protection offered, and the sharing of responsibilities between central and local authorities.only subscribers can see the full article
Keywords: Europe :: elderly care :: Spain :: Long-term Care :: Aging ::

Long-Term Care Reforms in England: A Long and Unfinished Story

Articolo scritto da:

The paper presents the main changes that have been introduced in the English Ltc system in the last two decades. After a general description of the structure of the long term care system as it has historically developed in England in the last 50 years, the essay addresses the main changes that occurred as a consequence of the 1993 community care reforms and of the following new programmes that have been introduced after that, aimed at empowering consumer choices, at better recognising the rights of disabled people, and at offering a new cash for care programme. Finally, a review of the role played by social and institutional actors in the revision of the system is presented.only subscribers can see the full article
Keywords: Europe :: elderly care :: Long-term Care :: Aging :: England ::

Demand, Measures and Systems of Long-Term Care in European Countries: A Comparative Picture

The contribution contextualizes the analyses carried out in the other studies in this number of the Rivista, offering a general reference frame for Ltc policies in Europe. If the other essays offer an analysis of the processes and quality of what is happening in the field of policies for the non-self-sufficient, here there is a useful quantitative basis that can provide a comparative view of the various countries under study against the more general background of the changes in social demand and institutional responses. The essay is structured around four themes: the characteristics and changes in the demand for care for the non-self-sufficient; the organization of informal care; the organization of public supply; and the effects of the various «care regimes» on the users and on their informal carers.only subscribers can see the full article

Policies for Long-Term Care in Sweden: Trends, Moving Forces and Consequences

Articolo scritto da:

Sweden has a well-developed system of long term care, based on taxfunded services that are mainly publicly provided. This system has changed significantly in the last few decades. Following the way in which the policy agenda is structured in Sweden, this paper focuses on elderly care, but some of the key interactions between the disability and elderly care systems are discussed, as well as the boundaries between elderly care and health systems. The main trend in provision of elderly care has been, counter to most other European countries, reduced expenditure and coverage of services, but also a very low and falling coverage of cash benefits for family carers. As a consequence of this trend, there has been an off-loading to unpaid family care (informalisation) as well as to privately financed and privately provided market care (marketisation).only subscribers can see the full article
Keywords: Europe :: Sweden :: elderly care :: Long-term Care :: Aging ::

Institutional Change and Gradual Development in Obligatory Insurance for Long-Term Care in Germany

Articolo scritto da:

The introduction of Long-term Care Insurance in 1995 in Germany brought a fundamental change in long-term care policies related to social rights, mode of funding and care provision. Before the introduction, long-term care was defined as a responsibility of (mainly female) family members with public support means-tested. The essay examines the principles of Long-term Care Insurance and some significant adaptations since then. It draws on a new-institutionalism approach and analyses the role of actors, their interests and ideas as well as institutional conditions of the reform process. In addition, it considers the reform’s effects. The research reveals both processes of fundamental change and gradual adaptations.only subscribers can see the full article
Keywords: Europe :: Germany :: elderly care :: Long-term Care :: Aging ::

The Reform Process in Long-Term Care Policies in Countries of the European Union: An Attempt at Interpretation

Articolo scritto da:

The essay offers a general interpretation of the changes taking place in long term care (Ltc) policies in the last 20 years in Europe. More specifically, the essay provides three general conclusions. The first concerns the general impact of the reform of Ltc policies in terms of retrenchment, restructuring or expansion. The second is related to the functioning of the political mechanisms and institutional processes through which change has been made possible, notwithstanding financial pressures and strong institutional resistance to innovation. The third is the impact of change on workers and providers in the Ltc field.only subscribers can see the full article

Paths for Change in Long-Term Care Policies in Denmark

Articolo scritto da:

Among the Nordic countries (and together with Norway) long term care policies in Denmark are the most universalist in terms of coverage; further, in contrast to the other Nordic countries, Denmark combines institutional change from below (non-legislative changes) with institutional change from above (legislative changes). The paper describes these changes, that have been oriented towards a marketisation and a better tailoring of services to individual needs. Taken together these lead to contradictory developments towards both standardisation and flexibility. The analysis will show how innovation has two, potentially contradictory sides: it is concerned with both «securing » and «extending» the welfare rights of citizens and therefore encompasses both measures of control and measures of free choice.only subscribers can see the full article
Keywords: Europe :: elderly care :: Long-term Care :: Aging :: Denmark ::

The French Path towards a Policy for Long-Term Care: Specific Features, Nature of the Process and Subjects Involved

Articolo scritto da:

France is characterized by the introduction of a new Ltc program (the Apa, Allocation Personaliseè a l’Autonomie) since 2002, providing a combination of service and cash to the dependent elderly population. The paper describes the factors leading to this reform and the political process that has characterized its approval and following implementation. In recent years there have been new changes, potentially leading to stronger recognition and public support of private long term care insurance. This turn towards the market will be analytically discussed, showing the political process and the actors that have been involved, and looking at the possible social and institutional impacts of the marketization of long term care.only subscribers can see the full article
Keywords: Europe :: France :: elderly care :: Long-term Care :: Aging ::


Articolo scritto da:

Every day it becomes clear that the limits to public-sector growth in the social services and the ongoing socio-demographic changes over the last twenty years are forcing us to reconsider, at both national and European level, feasible ways of tackling the care needs of the elderly. The ageing of the population has brought out two main problems: on the one hand, there has been an increase in the number of old people who require public assistance; on the other, there has also been an increase in the financial pressure imposed on traditional intervention programmes due to the additional social demand and to the strain it puts on public resources. It is this contradictory combination of factors that has led to both the difficulties that the various welfare systems find in carrying out policy reform for long-term care that can deal with this new social emergency, and the overall stop-go, if not inertia, of the ongoing processes of institutional reform in the various European countries. As this research shows, these processes are the prevailing feature, along with the widespread recalibrating of existing policies and interventions, both in terms of their structure and what is on offer.only subscribers can see the full article