Re-conceptualising the relationship between de-familialisation and familialisation and the implications for gender equality – the case of long-term care policies for older people

2018 ◽  
Vol 40 (4) ◽  
pp. 869-895 ◽  
Author(s):  
Thurid Eggers ◽  
Christopher Grages ◽  
Birgit Pfau-Effinger ◽  
Ralf Och
Keyword(s):  
Older People ◽  
Gender Equality ◽  
Social Protection ◽  
Long Term Care ◽  
Welfare States ◽  
Theoretical Assumption ◽  
Term Care ◽  
And Gender ◽  
The Relationship

AbstractThis article explores how far the concepts of de-familialisation/familialisation are adequate to the classification of long-term care (LTC) policies for older people. In the theoretical debate over LTC policies, de-familialising and familialising policies are often treated as opposites. We propose re-conceptualising the relation between de-familialisation and familialisation, arguing that they represent substantially different types of policy that, in theory, can vary relatively autonomously. In order to evaluate this theoretical assumption, this article investigates the relation between the generosity level of LTC policies on extra-familial care, and the generosity level of LTC policies on paid family care, introducing a new multi-dimensional approach to measuring the generosity of LTC policy for older persons. It also explores the consequences of this for gender equality. The empirical study is based on a cross-national comparison of LTC policies in five European welfare states which show significant differences in their welfare state tradition. Data used are from document analysis of care policy law, the Mutual Information System on Social Protection, the European Quality of Life Survey and the Organisation for Economic Co-operation and Development. The findings support the argument that de-familialising and familialising LTC policies can vary relatively independently of each other in theory. It turns out that we get a better understanding of the relationship between LTC policy and gender equality if we analyse the role of different combinations of extra-familial and familial LTC policies for gender equality. The paper brings new insights into the ways welfare states act in regard to their LTC policies. It helps to clarify how the concept of de-familialisation/familialisation can be understood, and what this means for the relationship between LTC policies and gender equality.

scholarly journals Long-Term Care and Gender Equality: Fuzzy-Set Ideal Types of Care Regimes in Europe

2020 ◽  
Vol 8 (4) ◽  
pp. 92-102 ◽  
Author(s):  
Attila Bartha ◽  
Violetta Zentai
Keyword(s):  
Gender Equality ◽  
Fuzzy Set ◽  
Long Term Care ◽  
Ideal Type ◽  
Term Care ◽  
Ideal Types ◽  
Intergenerational Ties ◽  
And Gender ◽  
Care Regimes

Recent changes in the organization of long-term care have had controversial effects on gender inequality in Europe. In response to the challenges of ageing populations, almost all countries have adopted reform measures to secure the increasing resource needs for care, to ensure care services by different providers, to regulate the quality of services, and overall to recalibrate the work-life balance for men and women. These reforms are embedded in different family ideals of intergenerational ties and dependencies, divisions of responsibilities between state, market, family, and community actors, and backed by wider societal support to families to care for their elderly and disabled members. This article disentangles the different components of the notion of ‘(de)familialization’ which has become a crucial concept of care scholarship. We use a fuzzy-set ideal type analysis to investigate care policies and work-family reconciliation policies shaping long-term care regimes. We are making steps to reveal aggregate gender equality impacts of intermingling policy dynamics and also to relate the analysis to migrant care work effects. The results are explained in a four-pronged ideal type scheme to which European countries belong. While only Nordic and some West European continental countries are close to the double earner, supported carer ideal type, positive outliers prove that transformative gender relations in care can be construed not only in the richest and most generous welfare countries in Europe.

scholarly journals Geospatial panorama of long-term care facilities in Brazil: a portrait of territorial inequalities

2021 ◽  
Vol 15 ◽  
Author(s):  
Tatiana Teixeira Barral de Lacerda ◽  
Ana Paula Miranda Neves ◽  
Giselle Layse Andrade Buarque ◽  
Denise Cuoghi de Carvalho Veríssimo Freitas ◽  
Mariana Medeiros Mota Tessarolo ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Long Term Care ◽  
Secondary Data ◽  
Term Care ◽  
The North ◽  
Care Facilities ◽  
The Relationship ◽  
Different Sources

OBJECTIVES: To map the number and geospatial distribution of Brazilian long-term care facilities (LTCFs) for older adults. Additionally, we sought to highlight the relationship between these findings and the number of older people in the country’s 27 Federation Units, demonstrating the growth of these facilities in the last decade. METHODS: This is a descriptive observational study, using secondary data, which was performed in 3 stages: 1) searching and consolidating national and subnational data from different sources and mapping LTCFs; 2) preparing a geospatial map using Brazilian postal codes; and 3) triangulating the number of facilities and of older people in each state and all 5 Brazilian regions. RESULTS: We found 7029 LTCFs in the country, mostly in the Southeast and South regions: São Paulo, Minas Gerais and Rio Grande do Sul had the highest numbers of facilities while states in the North region represented only 1.12% of Brazilian LTCFs. Geospatial mapping highlighted that 64% of the 5 570 Brazilian municipalities did not have any LTCFs for older adults. CONCLUSIONS: We observed a large difference between Brazilian regions regarding the provision of long-term care.

scholarly journals Gender equality and the governance of long-term care policy: new comparative models and paradigms

2020 ◽  
pp. 1-18
Author(s):  
Kirstein Rummery
Keyword(s):  
Welfare State ◽  
Gender Equality ◽  
Long Term Care ◽  
Care Policy ◽  
Term Care ◽  
New Models ◽  
Care Policies ◽  
And Gender ◽  
The Way

Abstract There is a long-established link between care policies and gender equality outcomes, and much modelling of welfare state typologies look at care provision as a distinguishing feature. However, to date, little research has been done which has systematically and critically examined those links by examining the policies and the way they operate, how and why they affect gender equality, and the governance of care policies in a comparative way. This paper draws on evidence from a recently completed comparative study looking at long-term care and gender equality. A CQA (Comparative Qualitative Analysis) approach was used to identify case studies, and further analysis carried out which focussed on: overall, how the policies and the way they operated to achieve gender equality; the governance and design of policies that led to good gender equality outcomes; the level of policy making; the role of the state, the family, the community and the nonstatutory civic sector in designing and delivering effective policies; and how context specific the ideas, actors and institutions supporting the policies were. Instead of using existing welfare typologies that were not driven by gender equality as the defining outcome variable, the author takes an inductive approach to policy analysis to compare policy outcomes according to gender equity outcomes. She devises two new models of long-term care policy: the Universal Model and the Partnership Model, both of which lead to improved gender equality in different ways. This paper concludes by noting the need to move beyond existing welfare state typologies in examining gender equality outcomes, which will result in new models as depicted here.

scholarly journals Exploring the relationship between depression and different multimorbidity patterns among older people covered by long-term care insurance in Shanghai, China

2021 ◽  
Author(s):  
Cancan Li ◽  
Wenjia Peng ◽  
Mengying Li ◽  
Xinghui Li ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Long Term Care ◽  
Depression Scale ◽  
Degenerative Disease ◽  
Cross Sectional ◽  
Term Care ◽  
Long Term Care Insurance ◽  
The Relationship

Abstract Background: Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long-term care insurance in Shanghai, China.Method: This was a population-based cross-sectional study, and participants included older people covered by long-term care insurance in Shanghai. We collected information on chronic conditions using a self-reported medical history, and we used the 30-item Geriatric Depression Scale to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms.Results: Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataract showed strong associations with depression when co-occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio [AOR] 1.223; 95% confidence interval [CI] 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms.Conclusion: Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long-term care insurance.

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