User Fees Of Home Care Services Pose A Risk Of Poverty And Care Deprivation For Older People With Low Income
1Institute for Health and Welfare, Finland; 2University of Jyväskylä, Finland
Ageing in place has become one of a key aims of the care policy in Europe. A growing number of older people find themselves in need of long-term care at home and with paying user fees for those services. The costs of health and social care have become a remarkable economic burden for many elderly people. Yet, only little is known about the scale and the regional differences of the financial burden of home care services.
According to the legal regulation, user fees may not “endanger the subsistence of the person or the family” in Finland. This principle is not always attained as the service fees easily constitute considerable monthly costs and, at the same time, almost one in five older persons are making their ends meet with low incomes. Research shows that expensive user fees are one of the main reasons for unmet needs.
Here, our data consists of information of the user fees of home care services from Finnish municipalities. In addition, user fee data was collected on assistive services. In order to evaluate the average financial burden for individuals (fees as a share of income), income data for households' average disposable income was obtained from Statistics Finland.
According to our preliminary results the user fees of necessary and inevitable services alone may add up to one third of the monthly income or even more. In addition there is significant variation in the user fees between municipalities. Thus user fees of home care services may cause a risk of poverty and care deprivation for elderly. Results highlights the need for care policies to focus on equality and affordability of care.
Family Care and Its Impact on Women’s and Men’s Retirement Decisions in Germany
German Centre of Gerontology (DZA), Germany
Objective: This study addresses the relationship between taking on unpaid care for an ill, disabled or frail elderly family member (‘family care’) and individuals’ retirement decisions in Germany.
Background: While individuals in their late career are increasingly confronted with family care tasks, the latest German pension system reforms aimed at postponing retirement entry and at the lengthening of lifetime employment. Therefore, the question arises whether, and if so to what extent, these conflicting expectations are associated with family caregivers’ retirement decisions.
Method: Data came from the nationally representative German Socio-Economic Panel Study (SOEP, 2001–2016). Using Cox shared frailty regressions, this study examines how different family care indicators are associated with women’s and men’s transitions from paid work into retirement.
Results: Family care is associated with women’s and men’s retirement decisions. In particular, family care intensity plays a crucial role: only those women and men providing extensive family care show an increased propensity to transition into retirement earlier compared to their non-caregiving counterparts.
Conclusion: The first findings reveal the importance of disentangling family care into low- and high-intensity family care for analyzing transitions into retirement.
Implications: This study highlights a policy mismatch that it is likely to apply to most western industrialized countries confronted with rapidly aging populations: even if desired by policy makers, some individuals cannot maintain their employment over the course of family caregiving and tend to withdraw from the labor market completely.
Informal Caregivers and the Impacts of Images of Aging. Insights and Reflections from a Qualitative Study
University of Siegen, Germany
The demographic change of the population worldwide is also accompanied with an increasing proportion of elderly people suffering from chronic illnesses. In Germany, most of the care is practiced at home (Federal Statistical Office for Germany, Care Statistics 2018). My contribution will not focus on the elderly sick people, but highlight the informal caregivers that are often their relatives, of old age themselves (from sixty years old), with declining physical and mental capacity and often under constant stress due to the 24/7-care situation. I’m going to reflect on insights from my qualitative research (participant observation, interviews, photos) in five families in a rural area in Germany that I carried out over more than a year in a completed research project. Most of those elderly informal caregivers were in their seventies and long-term caregivers for their sick spouse with dementia, Alzheimer’s or Parkinson’s disease for at least four, mainly ten years. Whilst the focus of my research was on the everyday practices of caregiving, another key aspect emerged in the field and from the data: the multi-facetted and dynamic aspects of ageing respectively the underlying images of aging. Age can be seen as a “transition” stage in general, but as a specific challenge when becoming an informal caregiver, in many times quite suddenly. Furthermore, there are discrepancies between the self-images of the elderly informal caregivers and the imposed images of ageing, for instance by (care) institutions, organizations, politics, public media, relatives etc. that will be discussed in the paper.