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

The coming of an aged society in Taiwan: issues and policies

W.-I. Lin

Asian Social Work and Policy Review, vol.4, 2010, p. 148-162

Taiwan became an ageing society in 1993, and by 2025 older people will make up one-fifth of the population. This article explores the impact of population ageing on health care, family and social care, and economic security, and government policy responses. Issues under consideration include the role of families, the government, non-governmental organisations, and commercial enterprises in the care and support of the elderly.

The introduction of a targeted user-pays approach to funding high-level residential aged care in Australia: an empirical investigation of the impact on price

S. Gargett

Health Economics, Policy and Law, vol. 5, 2010, p. 481-508

In response to predictions that population ageing will increase government spending over the coming decades, in 1997-98, the Australian government introduced means-tested care fees and accommodation charges for those admitted to nursing homes with income and assets above set threshold levels. Immediately prior, all residents paid the same price for their care and were not required to contribute towards the cost of their accommodation. In relation to those eligible to pay a higher price, the government reduced its subsidisation of the cost of their care. The government anticipated that the initiative would more equitably share the cost of age-related services across the public and private sectors, and result in some cost savings for itself. The purpose of this study is to assess the impact of the policy on the average price paid by residents. The findings suggest that the policy may have contributed to an increase in the average price paid, but statistical evidence is limited due to a number of data issues. Results also indicate that the rate of increase in the price was greater after the Residential Aged Care Structural Reform package was introduced. The study contributes to the economic analysis of the sector by evaluating time series estimates of prices paid by residents since the early 1970s.

'Last orders': dying in a hospital setting

R. Pockett, E. Walker and K. Dave

Australian Social Work, vol. 63, 2010, p. 250-265

This data mining study reviewing medical records of patient deaths in Australia provides a snapshot of the experience of dying in hospital, the incidence of documented advanced care planning, and the utilisation of social work services. The findings suggest that social work has an important continuing role in this area as an enabler and facilitator of decision-making processes in hospital settings. In end-of-life situations, social work interventions may be required to establish the reliability of surrogate decision-making, mediate between family members in the event of disagreement, and advocate on behalf of the patient or family with the treating team. This paper discusses elements that contribute to a supportive environment for patients and family members to facilitate decision-making, including the need for a broader ethical discourse to accommodate the increasing complexity of end-of-life decision-making in hospital settings.

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