Welfare Reform on the Web (January 2011): Care of the elderly - overseas

Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?

M.E. de Boer

Health Policy, vol. 98, 2010, p. 256-262

The Dutch euthanasia legislation passed in 2002 allows physicians to kill off mentally incompetent patients, including elderly people with dementia, on the basis of an advance directive as long as due care requirements are met. This research sought to obtain insight into current practice regarding advance directives and euthanasia in cases of incompetent patients with dementia in nursing homes. Data were gathered through a written questionnaire completed by 434 elderly care physicians. Results show that in 2005/06, many elderly care physicians took care of nursing home patients with dementia and an advance directive for euthanasia, but rarely actively terminated their lives, and never in the case of incompetent patients. The impossibility of patient-physician communication to establish the patient's current views appears to be behind this reluctance.

Ageing populations and housing needs: comparing strategic policy discourses in France and England

S. Hillcoat-Nalletamby and others

Social Policy and Administration, vol. 44, 2010, p. 808-826

This article contrasts recent strategic policy discourses developed by English and French governments in response to population ageing and its implications for the housing needs of an increasingly large group of older people. The English policy discourse emphasises the role that housing can play in promoting independent living and active ageing, and reducing reliance on state-funded social and medical care. In France, housing does not play a key role in ageing policy. This stance reflects the French government's acceptance of 'legitimate dependency' in later life and its willingness to accommodate it as a collective responsibility.