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Session Overview
RN01_01b_IC: Care Policies
Wednesday, 30/Aug/2017:
2:00pm - 3:30pm

Session Chair: Alexandra Lopes, Porto
Location: Intercontinental - Ypsilon II
Athenaeum Intercontinental Hotel Syngrou Avenue 89-93 Athens, Greece Floor: Level 1

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Care gap and the Care Mix in Europe: Exploring Modes of Long Term Care across European Countries

Platon Tinios2, Thomas Georgiadis1, Zafiris Valvis2

1Panteion University of Political and Social Sciences, Greece; 2University of Piraeus, Greece

Ageing in Europe has increased the need for Long term care (LTC). LTC meets similar needs through strikingly different means in different contexts.This paper uses data obtained from the fifth wave (2013) of the Survey of Health Ageing and Retirement in Europe (SHARE) of people aged 50+ as a means to benchmark LTC in fifteen European countries from the North to the South. The focus is on two key indicators: The Care Gap, that is, the extent to which the need for care is not met by any kind of provision, and the Care Mix, that is, how the overall provision is split into formal (professional - public and private), and informal care (unpaid care by family, friends or neighbours). Basic findings for the 65+ population are supplemented by an analysis by large age groups and gender. The findings on heterogeneity by systemic features and by individual characteristics feed into an analysis that treats LTC as social investment. They can explain differences in the nature of social investment, the flows of potential costs and benefits and their distribution but also on the identity of those undertaking long term care social investment decisions.

Care in times of choice and competition – A synthesis of the concept(s) of care and their relevance for mainstream economics

Ricardo Rodrigues

European Centre for Social Welfare Policy and Research, Austria

The introduction of market-based mechanisms for the provision of care has been one of the defining characteristics of changes introduced in long-term care (LTC) systems. This transformation explicitly portraits users as consumers of care and implicitly assumes care to be a conventional commodity liable to be traded in marketplaces. The concept of user as consumer of care has triggered a broad debate, but a similar discussion on the concept of care as a commodity and its implications for the theories underpinning choice and competition have thus far lagged behind. This paper aims to bridge this gap by contributing to engage the diverse literature on care with the literature on choice and competition and critically synthesizing the implications that the concept of care has for market-based developments in LTC. Drawing on a range of mostly theoretical literature, the paper argues that the concept of care as a relationship, central to feminism literature, and motivations for caring based on moral obligations have significant implications for choice and competition. They establish care as an experience good based on intangible caring relationships; whilst also pointing towards the potential for LTC to be morally contested commodity. The latter argument is of crucial importance in the context of choice, as it highlights the relevance of the concept of social embeddedness to understand users’ decisions and questions the role of money in caring transactions that might be better described as gift exchanges akin to Akerlof's depiction of certain labour market transactions. The paper concludes by arguing the direct relevance of these findings for policy and research.

Can an expansion of informal care significantly reduce the need for institutional care for the elderly?

Mark Elchardus

Vrije Universiteit Brussel, Belgium

The paper is based on a pure probability sample of 2891 inhabitants, 45 tot 75 years old, living in de Flemish (Dutch speaking) region of Belgium, drawn on the basis of the national population register (the net respons rate was 53%). The suvey dealt with various aspects of aging, dependency and care. The present paper focuses on two questions: (1) to what extend does the present level of informal care for dependent elderly person avoids or postpones long term institutional care, and (2) can a further increase of informal care be expected.

On the basis of the survey it is estimated that the 2.3 milion people aged 45 tot 75 living in the Flemish region, currently invest 123.000 full time equivalents in care, wich postpones or avoids about 71.000 placements in institutional care (compared tot the currently existing 75.000 beds currently available in the region). Clearly, informal care currently contributes very importantly to care for the dependent elderly people.

Former care givers were also asked if the institutional placement of the dependent person for which they cared, could haven been postponed or avoided. On the basis of their answers it is estimated that, under ideal conditions, this would only be the case for 3000 tot 6000 dependent persons. A further expansion of informal care can not be significantly counted on to slow the rate at which institutional care will have expand i the next 15 years.


Characteristics and determinants of intergenerational transfers among families using mixed care for older people

Valentina Hlebec, Masa Filipovic Hrast

Univerity of Ljubljana, Slovenia

Provision of care to dependent old parents or parents in law is an important part of intergenerational exchanges within families, especially in countries where long-term care system is based predominantly on family care. However, in mixed care networks, comprised from family carer(s) and formal carer(s), care tasks are shared between family members and formal carers. Apart from care shared by formal and informal carers, adult children and their parents may have financial and time exchanges. We will use the first Slovenian national survey of social home care users and their family members, collected in 2013 to observe characteristics and determinants of intergenerational transfers among families that use mixed care, i.e. a combination of formal and informal care for older people. We will observe the main determinants of intergenerational transfers within the diads of users and their family carers, such as household type, age, distance between caregiver and care-receiver, and extent of care tasks.

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