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RPS 1 2018

Il numero 1 2018 in uscita ad aprile, dedica la sezione monografica a genere e welfare, con un focus sull’Italia in prospettiva comparata.

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elderly care

Long-Term Care Reforms in the Netherlands

Articolo scritto da:

The foundation of the current Dutch long-term care system dates back to the end of the 1960s, when compulsory social insurance to cover the costs of «exceptional medical expenses» (Awbz) was introduced. Since then the system has undergone a continuous process of reform. The essay reconstructs the original logic of the system through a historical and institutional analysis. Then the trends towards reform are considered, looking at how the problem of change has been constructed and at the actors playing a relevant role in this process. All these aspects are described and critically reviewed in order to understand the directions and impacts of institutional change.only subscribers can see the full article

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 ::

Health Cost of Ageing: Truth, Myths and Clichés

in the issue
The heavy burden of health spending on elderly care is common-place in the preoccupations of policy makers and politicians, and is constantly the focus of media attention. The attention on this subject is however rather ambivalent: stress is not placed on the «physiology» of growth in investments for a part of society that «obviously» expresses several needs and is entitled to corresponding rights; the objective complexity of the problem is presented in such a way as to make the solutions appear increasingly more difficult and not due, with the consequent rise in cultural, political and cognitive marginalisation. Analysing four model scenarios, operative solutions, feasible through a participatory way, are indicated at both the local and general levels.only subscribers can see the full article

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 Application of Isee to Social Services for the Elderly. Its Experimentation in the Rome City Council

Articolo scritto da:

The reform of article V of the Constitution and the process which will lead to the definition of the Lep represent fundamental factors to analyse prospects in the Italian welfare model. Indeed the setting up of the social policy information system acquires a strategic function, whereas the Isee system represents a first important step. This premise introduces the experience initiated by the Rome City Council, which is particularly significant in the field of selective policies applied by social services. In fact, through an integration of the Isee calculation mechanisms, consented by the norm, it was possible to take account of the specific characteristics of the elderly and set specific policy objectives.only subscribers can see the full article

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