ALLOCATION OF RESPONSIBILITIES BETWEEN THE CARE ACTORS

In this book, the pressing issue of ageing societies in the EU has been brought to the fore. Ageing societies present questions which are not all new as such – as demonstrated by Froukje Pitstra‘s contribution in this volume – but whose impact and degree of difficulty have reached unprecedented levels in recent history. It is not merely a matter of ageing populations, but also that this is combined with a preference by the elderly to continue being cared for in their own homes for as long as possible. This coincides with the wishes of policymakers to unburden the welfare state, since care at home is less costly than that received in a dedicated institution or nursing home. The European Commission expects that the ratio split of old-age dependency (that is, people aged 65 or above relative to those aged 15–64) is projected to increase in the EU from 28% to 50% by 2060. By then, 35 million people are expected to need long-term care. The EU has expressed its concerns regarding the long-term budgetary effects and challenges for public finances that this would represent, just as many individual EU member states have done.

The need to unburden the welfare state appears to be inevitable. This objective is in contrast to the tendency in previous decades to shift this care burden onto the state, though some notable differences exist across Europe in this respect. The rise of the welfare state in the second half of the twentieth century has had a huge impact on the redistribution of care tasks between the various care actors in a number of countries. While in earlier (pre-welfare state) societies the family and other informal networks used to be the only safeguard for the risks associated with old age, today these risks are covered by public policy and social security systems in particular. However, this approach seems to no longer be sustainable. In countries with a high level of state care, a slow transition is taking place towards the promotion of informal care; whereas in countries with a traditionally strong emphasis on informal care, policy is aimed at improving state-financed care.