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Welfare Reform on the Web (September 2010): Care of the elderly - overseas

Ageing in the neighbourhood: creating caring communities and increasing liveability in Dutch neighbourhoods

G. Heins

Journal of Urban Regeneration and Renewal, vol. 4, 2010, p. 53-62

The Netherlands has a growing elderly population, many of whom face loneliness and isolation. Policies are being developed to reduce loneliness and passivity by increasing the participation of older people in society. This paper proposes a model for activating older people based on the premise that a neighbourhood in which older people are actively involved will be capable of providing them with care and attention when needed.

The burden of long-term care: how Italian family care-givers become employers

F. Degiuli

Ageing and Society, vol.30, 2010, p. 755-777

In recent years in Italy, population ageing, the increased participation of women in paid work, and the restructuring of the welfare state have led to increased demand for long-term care services for frail older people. This rising demand has increasingly been met by immigrant women of different nationalities, and to a lesser extent immigrant men, who have been hired to provide individualised care in people's own homes and other private settings. This article explores, through interviews with 26 family members, their reasons for choosing this care and support option, and their attitudes towards the welfare state and the care labour market. The majority of respondents advocated a stronger role for the welfare state in helping families cope with the increasing burden of long-term care.

Elder abuse in long-term care residences and the risk indicators

M. Cohen and others

Ageing and Society, vol.30, 2010, p. 1027-1040

Elder abuse is a prominent problem in residential care institutions. It includes physical, psychological and sexual abuse, financial exploitation, passive or active neglect, and violation of rights. This study is the first to assess the prevalence and correlates of elder abuse in long-term care facilities in Israel, using direct questioning, by identifying signs of abuse and through the calibration of risk indicators. The results showed a low prevalence of physical abuse, but much higher rates of psychological mistreatment, violations of privacy and other humiliating behaviours. Direct questioning of non-demented residents mainly disclosed instances of disrespectful behaviours and humiliation, while assessment of signs of abuse was more sensitive to cases of neglect. Risk indicators were found to be reliable indicators of abuse.

Ethical dilemmas in the provision of end-of-life care in Norwegian nursing homes

E. Gjerberg and others

Social Science and Medicine, vol. 71, 2010, p. 677-684

Nursing home staff in Norway face numerous ethical challenges in delivering end-of-life care to residents that meets physical, social and emotional needs while at the same time treating patients with dignity and respect. Issues include questions regarding respecting patients' autonomy, particularly with regard to demented patients, and decisions about life-sustaining therapies. If ethical challenges are not handled appropriately, they may negatively affect quality of care and create stress for nursing home staff, patients and relatives. It is thus important to provide in-service training and arenas for discussion in order to enable staff to cope with ethical challenges effectively.

The last year of life in Europe: regional variations in functional status and sources of support

K. Hank and H. Jurges

Ageing and Society, vol. 30, 2010, p. 1041-1054

This article aims to provide an initial account of the life circumstances of older people in 11 continental European countries during the year prior to their deaths. It focuses on regional variations in older people's functional limitations in performing the activities of daily living, in sources of support (family vs non-kin), and in places of death, based on unique data from the Survey of Health, Ageing and Retirement in Europe. The prevalence of functional limitations was found to be fairly consistent across Northern, Central and Southern Europe. Significant regional differences emerged, however, with regard to the deceased respondents' main sources of support and the location of their deaths. Northern Europeans were the least likely to receive help from their family only, and the most likely to be supported by non-kin. They also exhibited the highest risk of dying in a nursing home. In Mediterranean countries, a pattern of exclusive family support and dying at home prevailed.

Long-term care

CESifo DICE Report, vol.8, Summer 2010, p. 3-39 This forum offers articles covering issues and challenges around the provision of long-term care for older people in Europe, including public expenditure in EU member states, the role of family solidarity, insurance schemes in France and Germany, and quality improvement.

Long-term care in Europe

J. Costa-Font (guest editor)

Social Policy and Administration, vol. 44, 2010, p. 357-528

The articles in this special issue aim to influence the policy and scholarly debates on how best to reform the organisation and financing of long-term care for older people in Europe. All the papers focus on a particular issue regarding the reform of long-term care in their specific country of study.

Long-term care in Israel: challenges and reform options

D. Chernichovsky and others

Health Policy, vol. 96, 2010, p. 217-225

This paper studies the long-term care system in Israel, which is fragmented and marked by a multitude of public and private for- and not-for-profit funding and provision arrangements. In the absence of a comprehensive policy, these arrangements have not added up to a coherent publicly led system that can deal efficiently and equitably with existing and fast growing need. To remedy this situation, the paper suggests a two-stage reform. The first stage involves integrating the current fragmented publicly funded system and deciding whether long term care is a social or a medical endeavour. The second stage involves extension of universal entitlement to long-term care, which would relieve the taxpayer of a growing privately borne burden.

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