1st Edition

Long-term Care for the Elderly in Europe Development and Prospects

Edited By Bent Greve Copyright 2017
    210 Pages
    by Routledge

    210 Pages
    by Routledge

    Long-term care is an increasingly important issue in many contemporary welfare states around the globe given ageing populations. This ground-breaking book provides detailed case studies of 11 EU-member states’ welfare regimes within Europe to show how welfare states organize, structures and deliver long-term care and whether there is a social investment perspective in the delivery of long-term care. This perspective is important because the effect of demographic transitions is often used as an argument for the existence of economic pressure on welfare states and a need for either direct retrenchment or attempts to reduce welfare state spending. The book’s chapters will look specifically into how different welfare states have focussed on long-term care in recent years and what type of changes have taken place with regard to ageing populations and ambitions to curb increases in public sector spending in this area. They describe the development in long-term care for the elderly after the financial crisis and also discuss the boundaries between state and civil society in the different welfare states' approaches to the delivery of care.

    List of contributors




    Chapter 1. Long-term care – what is it about (Bent Greve)

    1.1. Introduction

    1.2. What is long-term care and the quest for quality

    1.3. Overview of the book

    1.4 Delimitations

    1.5. References

    Chapter 2. Long-term care for the elderly in Hungary (Róbert I. Gál)

    2.1 Introduction

    2.2.Overview of the long-term care system

    2.3 Being old

    2.4. Demand and supply


    2.4.2. Assessment of needs

    2.4.2. Available benefits and services

    2.4.3. Supply of public care

    2.4.4. Informal market for long-term care services



    2.7. References

    Chapter 3. Long-term care – challenges and perspective (Virginija Poškutė)

    3.1. Introduction

    3.2. Organisations of Long-term care

    3.3. Formal LTC for elderly

    3.4. Financing of LTC

    3.5. Boundaries between state and civil society in the approach to the delivery of care with an eye to the private sectors ambition to provide and sell care

    3.6. Informal care

    3.7. Use of rehabilitation and welfare technology as a way to improve quality of life and to reduce the pressure on public sector spending in the area.

    3.8. Summing up conclusions

    3.9. References

    Chapter 4. Long-Term Care for the Elderly in Poland (Zofia Czepulis-Rutkowska)

    4.1. Introduction

    4.2. New welfare state institutional context

    4.3. Demand for long-term care

    4.4. Supply of the long-term care


    4.4.2.Public Sector

    4.4.3Social sector

    4.4.4 Private sector and NGO’s

    4.5. Administration, financing and quality. Challenges.

    4.6.Debate and reform proposals

    4.7. Conclusions


    Chapter 5. LTC in Portugal: quasi-privatization of a dual system of care (Alexandra Lopes)

    5.1. Introduction

    5.2. Historical trends in the consolidation of social care for dependent elderly in Portugal: familism and quasi-privatization of care

    5.3. LTC in contemporary Portugal: provisions and providers

    5.4. The national network for long-term care: rehabilitation and integration of health and social care in the new millennium

    5.5. The financials of care provision

    5.6. Critical challenges for formal care provision if Portugal: LTC staff shortage and absence of quality assessment mechanisms

    5.7. Conclusion

    5.8 References

    Chapter 6. Long-term care in Italy (Emmanuele Pavolini, Costanzo Ranci and Giovanni Lamura)

    6.1. Introduction

    6.2. Developments in long-term care policies for older people

    6.3. The role of civil society in LTC delivery

    6.4. Long-term care amid increasing individual needs and diminishing family capacity

    6.5. A peculiar marketization: migrant care workers as the new cornerstone of the Italian LTC system

    6.6. Use of rehabilitation and welfare technology

    6.7. Quality measures and the quality of the Italian LTC system

    6.8 Conclusions

    6.9. References

    Chapter 7. Greece: Forced transformation in a deep crisis (Platon Tinios)

    7.1. Introduction

    7.2.The mixed system before the crisis

    7.3.The crisis and the care economy

    7.4. Conclusion: Long term care towards the end of the crisis

    7.5. References

    Chapter 8. Long-term care and austerity in the UK- a growing crisis (Caroline Glendinning)

    8.1. Introduction

    8.2. Recent developments in UK long-term care

    8.3. Personalisation and personal budgets

    8.4. Rehabilitation and reablement

    8.5. Austerity Policies

    8.6. The impacts of austerity

    8.7. The impacts on long-term care services

    8.8. The impacts on older people

    8.9. Private care markets

    8.10. The impacts on family care-givers

    8. 11. The impacts on care markets

    8.12. Conclusions

    8.13. References

    Chapter 9. Paradoxical decisions in German long-term care: Expansion of benefits as cost-containment strategy (Margitta Mätzke, Tobias Wiß)

    9.1. Introduction: The question of expansion

    9.2. Design of an unwieldy long-term care system


    9.4. Financing

    9.5. Recipient rates

    9.6. Who cares?

    9.7. Characteristics and governance structures in German long-term care

    9.8. The role of the market in long-term care

    9.9 Governance of long-term care

    9.10 Recent long-term care reforms

    9.11. The broader concept of care

    9.12. Modernizing long-term care: Reconciliation, monitoring quality, promoting rehabilitation

    9.13. Conclusion

    9.14. References

    Chapter 10. Long-term care expenditures in Finland (Ismo Linnosmaa and Lien Nguyen)

    10.1 Introduction

    10.2 Long-term care in Finland

    10. 2.1 Long-term care and services for older people in Finland

    10.2.2 Organization and financing of services for older people

    10.3 Economic and demographic development in Finland

    10.3.1 Public sector surplus in comparison to European countries since 2008

    10.3.2 Demographic development in Finland

    10.4 Expenditures on long-term care

    10.4.1 Total expenditures

    10.4.2 Expenditures on institutional care, home care and other services

    10.4.3 The share of private care

    10.5 Financing of long-term care

    10.6 Recent policy initiatives in the Finnish long-term care

    10.7 Summary and conclusions

    10.8 References

    Chapter 11. Long-term care in Denmark – with an eye to the other Nordic welfare states (Bent Greve)

    11.1. Introduction

    11.2. Central issues

    11.3. What is quality in Long-term care?

    11.4. Recent developments in the Nordic welfare state – an empirical focus

    11.5 Development in elder-care policies – central changes

    11.6. Conclusion – reformulation of welfare mix?

    11.7. References

    Chapter 12. Some concluding reflections (Bent Greve)

    12.1. Introduction

    12.2. Synthesis of development in long-term care

    12.3. Trends in marketization of long-term care

    12.4. Role of civil society

    12. 5. Austerity measures/Change in financing

    12. 6. Rehabilitation and/or re-enablement – new trends?

    12.7. Quality-measures including quality of life

    12.8. Final concluding remarks

    12.9 References


    Bent Greve is Professor of Welfare State Analysis at the Department of Society and Business, Roskilde University, Denmark.