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Caring by Contract: Care Arrangements for Older People

Published online by Cambridge University Press:  08 May 2020

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Summary

INTRODUCTION

Recent years have seen a wide and increasing diffusion of care arrangements for older people. This development has arisen owing to the convergence of multiple factors related to the pan-European problem of an ageing population with increasing demands for care. Although, of course, older people are not necessarily dependent on others for continuous non-medical care, the passing of the years does mean that many will eventually, in various ways, require assistance in performing daily tasks. Not only is the population ageing, but fertility rates across Europe are dropping, leading to the elderly constituting a larger proportion of the overall population and charging the growing costs of elder care to a shrinking number of tax-payers. Moreover, the rise of the nuclear family model, consisting of only two generations, parents and children, living together, and the increasing number of people seeking and finding employment out of their birth town have been weakening the function of the family as primary support structure for older people. The raising of retirement age and the growth of women's work outside the home further contribute to the diminution of informal caregivers available. In addition, the growing level of women's education and income from paid employment increases the economic resources of the family, making it economically more attractive for families to have women working outside their household and to hire caregivers for children and older dependent persons.

Besides, the crisis of the modern Welfare State, worsened by the global economic crisis, has been causing a reduction of quality and quantity in social services. The introduction of the so-called welfare mix model, in which social services are supplied both by the municipalities themselves and by the private sector, has further stimulated the development of private care arrangements. The moving of the hospital health system towards assistance only for severe acute condition increases the demand for palliative treatments and general care of the sort frequently required by older non-dependent persons. Indeed, “care” encompasses not just diagnostic and therapeutic action, but all other aspects of preserving mental and physical well being.

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Publisher: Intersentia
Print publication year: 2011

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