Long-Term Care Services in 4 European Countries. Labour Markets and other aspects

Titelblatt_Long_term_Services

Author: Karsten Krüger & Erik de Gier (Eds.)
Year: 2011
One of the European Union’s major concerns is its ageing population, and the need to develop a social and economic strategy able to meet this demographic challenge. One of the key issues is the care for elderly and dependent people. This question goes to the core of the European Social Protection system. But it is difficult to define exactly what care and care services for dependent people means. Traditionally a distinction has been made between health care and social care. For several reasons, these boundaries are blurred and a more integrated perspective comes up advocating the concept of long-term care, defined by the OECD as “the organisation and delivery of a broad range of services and assistance to people who are limited in their ability to function independently on a daily basis over an extended period of time”.
Long-term care systems are characterised by the diversity of the providers, of the institutional and organisational settings, and of the sources of funding. With regard to social care, the EUROFOUND made a rough distinction between waged carers and non-waged carers.
Only this distinction indicates yet that long-term care systems have complex configurations, combining different types of formal care with a wide range of informal care.
The long-term care systems of the EU-member states are under pressure from four quarters:
a) The improvement in the health of European populations has increased life expectancy. The over 65-year and the over-85 age groups have grown considerably in recent decades and will continue to do so in the future. Inevitably, this raised and will raise the demand for care for older people.
b) The family structure has changed all over Europe, towards a model characterised by smaller double breadwinner families. And as female members have traditionally taken responsibility for family care, the growing incorporation of women in the labour market increases the demand for formal carers.
c) The EU population in working age is decreasing, thus raising competition for labour between different economic sectors. This can be mitigated, but not resolved, by immigration. But low paid work and low labour status combined with high responsibilities make the care work not very attractive.
d) The retrenchment of the welfare state since the 1990s and the increasing public budget restrictions in EU-member states have made the funding of high quality national care systems even more difficult.
The multiple demographic changes exert pressure on the care service sector to respond to the increasing demand for professionalised care services. There is a lack of qualified labour to satisfy this demand, and there are strong public budget restrictions as well.
The problem of providing high quality care service is related on the one hand to the increase in the demand for care, and on the other to the labour shortage. But at the same time, long-term care is one of the sectors in which the most employment is created.
This book brings together articles by authors from four European countries (Finland, Germany, the Netherlands and Spain) which reflect trends in the search for new combinations between institutional, family and community agents to provide high quality long-term care services. The articles also show the diversity of the national landscapes of care services as well as the variety of possible solutions.

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