The aim of this special issue is to examine the relationships between support for older people and various socio-demographic, cultural and policy factors in selected European countries and the United States, using the international comparative perspective developed by the members of the Family Support for Older People: Determinants and Consequences (FAMSUP) network. Four of the included papers were delivered by network members at a symposium on ‘Family Support for Older People: International Comparisons’ that was held at the International Sociological Association (ISA) Inter-Congress Conference on Ageing Societies and Ageing Sociology: Diversity and Change in a Global World at the University of Surrey, Roehampton, in the suburbs of London (7–9 September 2004). Another paper, by Jim Ogg, a FAMSUP member, and Sylvie Renaut, investigates family networks among older people using data from the Survey of Health and Retirement in Europe (SHARE).

This paper introduces the Special Issue of four empirical studies on the provision of family support to older people that have been written members of the Family Support for Older People: Determinants and Consequences (FAMSUP) network. They have in common the use of individual-level data and recognition of the importance of demographic forces, cultural variations and public policy in shaping patterns of elder care. The four papers are also explicitly comparative, and emphasise both between- and within-country differences. The European countries examined by the FAMSUP researchers exhibit several broadly similar demographic trends, but these are superimposed on very different policy regimes. The ‘macro’ focus of much comparative policy-oriented research facilitates the identification and description of population ageing, while illuminating the policy issues raised by demographic change. A macro-focus is also characteristic of much comparative welfare-state analysis. The ‘micro’ orientation of the research presented in this collection typically treats the policy environment as an implicit or residual category. We argue that progress in understanding comparative patterns of elder care, and in developing policy responses to demographic change, will be facilitated through blending the macro and micro perspectives, in which variations in the policy environment are explicitly linked to individual- and family-level behaviour.

The ‘sandwich generation’ has been conceptualised as those mid-life adults who simultaneously raise dependent children and care for frail elderly parents. Such a combination of dependants is in fact very unusual, and the more common situation is when adults in late mid-life or early old age have one or more surviving parents and adult but still partly dependent children. It can be hypothesised that for parents in this pivotal position, the demands from adult children and from elderly parents compete, with the result that those who provide help to one are less likely to provide help to the other. An alternative hypothesis, however, is that family solidarity has an important influence but is not universal, so that some pivotal-generation parents engage in intergenerational exchange in both directions, and there is a positive association between helping parents and helping children. To investigate this question, the paper presents an analysis of data from two broadly comparable national surveys, in Great Britain and the United States, on the care provided by women aged 55–69 years to their descendent and ascendent relatives. The results show that around one-third of the women reported providing help to members of both generations, and that around one-fifth provided support to neither. They broadly support the solidarity hypothesis, but provide some evidence that having three or more children is associated with a reduced likelihood of providing help to a parent.

In 2004 in Europe, more than two-thirds of those born during 1945–54 had a parent or parent-in-law alive, and the rates of co-residence with their ascendants ranged from less than four per cent in Sweden, Denmark and The Netherlands, to between 17 and 24 per cent in Italy, Spain and Greece. The proportions that had provided practical help to their parents during the previous 12 months had a north-south gradient, from approximately one-in-three in the northern countries to 15 per cent or less in the southern countries. In contrast, the proportions of the helpers that provided regular and almost daily help had an inverse pattern, being low in Sweden and Denmark and much higher in the south. Some of these differences may be attributable to variations among the countries in the interpretation of ‘help’. Help to elderly parents tends to be most associated with the gender of givers and receivers, the living arrangements, geographical proximity and needs of the parents, and the availability of adult children who can help. There is little evidence of a specific ‘baby-boomer generation’ effect on the probability of giving help.

This study investigates the variations by older people's socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.

Old-age care has frequently been conceptualised as being either family-based or publicly-provided. This article analyses the overlap in provision from the two sources and their relationship in the Swedish welfare state. Many older people and their carers rely on both sources of help rather than on just one, and prefer to do so. The empirical evidence on patterns of care in Sweden supports a joint family-state conceptualisation of care. Its realisation may depend on general coverage rates of public services and the efficient targeting of frail elderly people who live alone. Most older people in need of care rely on help only from their family, but many are helped by both the family and the state, particularly those with the greatest needs. Dynamic concepts like ‘substitution’ and ‘complementarity’ are hard to apply in cross-sectional studies: there may be complementarity in individual cases but long-term substitution or its reversal in successive cohorts. Yet again, both sources of care may increase simultaneously in individual cases. The need for care varies considerably among Swedish municipalities, with implications for the levels of both public services and family support. High coverage rates of the public services may facilitate and support family care.

Since 1990, Albania has witnessed rural out-migration on a massive scale, both to other countries, chiefly Italy and Greece, and internally to Tirana and other major towns. The scale of this migration has disrupted the multi-generational rural social and kinship systems that, before 1990, displayed strong and coherent family bonds, and simultaneously accommodated paternalistic state directives and were supported by welfare provision for all members of the population. The sudden political, social and rural dislocations that followed the end of the communist regime have made older people particularly vulnerable: many have been left behind by their emigrant children, creating the phenomenon of socially-isolated ‘elderly orphans’. While the migrants' remittances cushion this social isolation, the loss of children and grandchildren through emigration has undermined older people's self-respect and raison d'être in Albanian family life. This paper, based on fieldwork and interviews in regions of heavy out-migration in northern and southern Albania, examines the human impact of emigration on the older people who have been left behind as well as their coping mechanisms, one being to follow their children abroad to care for the grandchildren, enabling the ‘middle generation’, working-age parents both to engage in paid work.