General information
Code: J5-8235
Period: 1.6.2017 - 31.5.2020
Range on year: 1.60 FTE | 2018
Project leader at FDV: prof.dr. Valentina Hlebec
Research activity: Social sciences
Abstract
Demographic ageing has raised questions about how to best provide quality, sustainable and affordable longterm
care (LTC) to dependent older people living in the community. There is a growing concern that reliance
on informal care alone for older people living in the community could have adverse effects on the well-being
and health of carers and result in a high level of unmet care needs. Supplementing informal care with care
services and support for carers may thus be a more efficient and effective way to care for an ageing population.
Understanding how public policies can impact the care mix (i.e. whether informal care, formal care or a
combination of both is used and for which tasks) is therefore crucial for policymakers to foster more efficient
use of care.
The adverse effects mentioned above disproportionately affect some groups, including those with limited
financial resources or those residing in rural settlements, which raises issues of equity. To date, there is a
dearth of empirical evidence on how different public policies across countries impact the use of different
types of care (i.e. informal care, formal care or both) and the distribution of care tasks (e.g. personal care,
domestic aid) between informal and formal carers among different groups of dependent older people (e.g.
concerning socioeconomic status). This could hamper the targeting of public policies and understate possible
equity issues related with public policies in LTC.
Regarding public policies, the available studies have mostly compared the impact of providing either cash
benefits (e.g. in Germany), which can be used to pay informal carers, or generous care services (e.g. in the
Nordic countries) on the type of care older people receive (informal care, formal care or both) and the
distribution of care tasks between informal and formal carers. These comparisons overlook the fact that the
majority of European countries have LTC systems that either rely by default on informal carers or support
informal carers as the main providers of care, thus falling short of the generous care service provision found in
some of the Nordic countries. Studying the impact of different forms of familialization in LTC is therefore
relevant for a wider European audience.
Within this context , our project aims to analyze how dependent older people and their families make choices
regarding the care mix and care tasks in LTC. In particular, we are interested in understanding how these
choices are influenced by the degree of familialization in policies for LTC and how they are differentiated for
different groups of dependent older people. In the context of this study, care mix is understood as the use of
informal and formal care, or both. The care tasks we consider include nursing care (e.g. putting on prostheses
or elastic stockings), personal care (e.g. assistance with dressing), domestic aid (e.g. help with household chores
such shopping or food preparation) and technical aid, as well as assistance with travel arrangements and
socializing. The study focuses on older people who co-reside with a spouse or children, or that otherwise live
alone but have children that is, on older people for whom the choice of informal care, besides formal care, is
an option.
The phases of the project and their realization
In order to address the six research questions defined above, we will use a mixed-methods research design (Creswell and Plano, 2007), basing our analysis on both primary (qualitative) and secondary (quantitative) data sources. The study will be carried out within four research work packages (WP), which can be generally thought of as sequential (WP2–WP5), although certain activities planned in consecutive stages can also be expected to overlap (see Figure 1 below and Table 1 in section 16). Two additional WPs will focus on the general project management (WP1) and dissemination activities (WP6). These are depicted as circumscribing and taking place alongside the research-based WPs that form the bulk of the project activities.
Work package 2 (Literature and legislation review) will address RQ1 and will aim to methodically catalogue the main system characteristics, policies and regulations, as well as other relevant contextual factors, and to develop precise hypotheses to be tested in subsequent stages.
Work package 3 (Quantitative analysis) will address RQ2 and RQ3 and will aim to explore the factors associated with differences in the care mixes and care tasks between the two countries.
Work package 4 (Qualitative analysis) will address RQ3, RQ4 and RQ5 and will aim to understand how dependent older people and their families select a given combination of care mix and care tasks and to what extent they are influenced by such factors as personal preferences, social benefits and regulations that impact intergenerational exchanges within the household in the context of care and/or cultural values.
Work package 5 (Comparative synthesis) will address RQ6 and will aim to synthesize and compare findings between and within countries and within and between quantitative and qualitative methods.
Research Organisation
http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=403&hits=1&id=12512&search_term=J5-8235
Researchers
http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=402&hits=1&id=12512&search_term=J5-8235
Citations for bibliographic records
http://www.sicris.si/public/jqm/prj.aspx?lang=eng&opt=2&subopt=400&hits=1&id=12512&search_term=J5-8235
Results / Key findings
By focusing on specific groups of the elderly population, the findings of this project went beyond an analysis of care mix and care tasks selection for the older population, to present insights into group differences within and across countries. Such results provided an evidence base for policy discussion on equality and equity in the old age and long-term care. In addition, the findings of this project reflected not only the impact of different public LTC benefits, but also the broader regulations impacting intergenerational exchanges. We hypothesized that the interplay between these two is of particular relevance in the context of the familialization of LTC systems, where families play a relevant role as care providers. Furthermore, we studied the impact of these factors on the care mix and also on care tasks, thus contributing novel results to the specialized literature. By including Slovenia as one of its exemplar countries, the project allowed for a country from the Central/Eastern European LTC regime to be analysed, extending the geographical coverage of previous studies and contributing to understanding how Central and Eastern European LTC systems fare in comparison to others. We explored the relationships between older people, their informal and formal carers and the care process as it takes place in daily care experience, and we assessed the factors that stimulate/hinder the use of formal and informal care in the specific welfare contexts of Austria and Slovenia. We also provided insights into the processes through which specific public policies impact the care mix and care tasks. We worked in a comparative research field and looked at the position of both countries and their welfare systems among other European countries´. We established whether the same or different factors influence the care models in different welfare contexts, with an emphasis on comparing Austria and Slovenia. By addressing these points, we will further develop the care models in a European welfare context.
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