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Welfare Reform on the Web (June 2004): Care of the Elderly - Overseas

CHANGES IN ELDERLY DISABILITY RATES AND THE IMPLICATIONS FOR HEALTH CARE UTILIZATION AND COSTS

B. C. Spillman

Milbank Quarterly, Vol. 82, 2004, p.157-194

Recent research suggests that physical disability among older Americans may be declining, and that this trend may reduce the expected rise in health care costs due to population ageing. The study used data from the 1984-1999 National Long-Term Care Surveys to better understand the reasons for the declines and potential implications for acute and long term care. Results showed that reductions in demand occurred for activities like financial management and shopping. Assistance with personal care due to frailty fell less, and independence with assistive devices rose. Institutional residence was stable. Any declines in demand for assistance may reflect environmental improvements allowing greater independence at any level of health, rather than improvement in health.

THE DIVERSITY AND WELFARE OF OLDER MIGRANTS IN EUROPE

A.M. Warnes and others

Ageing and Society, vol.24, 2004, p.307-326

Paper begins by discussing the socio-demographic processes that lie behind the growing number of older migrants living in European countries, namely population ageing and international migration. Then reviews the diversity of older migrants in European countries and presents a taxonomy of their welfare status and the accumulated "human capital" by which they can address their needs for income, treatment and care, and for material, social and emotional support.

FIXED LAWS, FLUID LIVES: THE CITIZENSHIP STATUS OF POST-RETIREMENT MIGRANTS IN THE EUROPEAN UNION.

L. Ackers and P. Dwyer

Ageing and Society, vol.24, 2004, p.451-475

In practice, the residency and social rights that a mobile EU national can claim in another member state depend on the type of social contribution they have made and their personal relationships. Contributions through paid employment and/or membership of the family of a mobile EU worker give rise to maximum social benefit. Whilst the European Union citizenship provisions extend residency rights to all EU nationals (irrespective of work status), those whose mobility is not connected to employment derive significantly inferior social entitlements when resident in a host Member State. The rights of people who move after retirement differ substantially from those who retire following a period of working in another member state.

THE ISRAELI KIBBUTZ AS A VENUE FOR REDUCED DISABILITY IN OLD AGE: LESSONS FORM THE CROSS-SECTIONAL AND LONGITUDINAL AGING STUDY (CALAS)

A. Walter-Ginzburg, T. Blumstein and J.M. Guralnik

Social Science & Medicine, Vol. 59, 2004, p.389-403

The article explores whether the kibbutz life can be associated with a lower risk of disability, and therefore better aging, by comparing kibbutz members, their parents and comparable members of the Israeli community. It examined the similarities and differences of the three groups with regard to their sociodemographics, health and health behaviours and life events. Kibbutz members were found to be less disabled, and had a 30% lower risk of disability than their peers. These findings indicate that it is the low incomes associated with blue collar and agricultural workers that have led to them being linked to poor health and disability, as the kibbutz differs from the general community only in that all occupations are rewarded equally and all members have complete economic security. This suggests that the social, economic and instrumental help and support provided by the kibbutz, combined with the active lifestyle, helps to reduce disability. The study concludes that the findings have important implications for social policy, as it suggests that disability could be reduced if economic, social and health care arrangements in communities where designed to mimic the major features of kibbutz life.

LINKAGES BETWEEN MIGRATION AND THE CARE OF FRAIL OLDER PEOPLE: OBSERVATIONS FROM GREECE, GHANA AND THE NETHERLANDS

S. van der Geest, A. Mul and H. Vermeulen

Ageing and Society, vol.24, 2004, p.431-450

Article explores how the care of frail older people is organised when children have emigrated. The solution developed is for absent children to hire a private carer, who may be a relative or an immigrant stranger, to look after the frail older person. This approach follows the rules of reciprocity and normally provides a good quality of care. Ironically, hiring a full time private carer is more feasible in low-income countries, but a rare luxury in high-income societies.

OLDER LABOUR MIGRANTS' WELL-BEING IN EUROPE: THE CASE OF SWITZERLAND

C. Bolzman and others

Ageing and Society, vol.24, 2004, p.411-429

Paper reviews the demography of the older immigrant population of Switzerland and examines aspects of their health and well-being, with a focus on their material standard of life and access to social security and related benefits. It reports selected findings from an original survey of older Italian and Spanish citizens resident in the country, which showed relatively high rates of disadvantage and poverty. Because of their short residence in Switzerland and a lifetime of low wages, their state pensions and occupational benefits are lower than those of the Swiss. They are not always entitled to supplementary benefits because they have not been resident in Switzerland long enough to be eligible. De facto, foreigners who are old and poor are expected to arrange a private solution to their poverty.

SUBSTITUTION IN STATUTORY AND VOLUNTARY SUPPORT FOR RELATIVES OF OLDER PEOPLE

L. Dahlberg

International Journal of Social Welfare, vol.13, 2004, p.181-188

Study examined local authority and voluntary support for family carers of elderly people in Sweden. Local authority activity did not seem to crowd out or substitute for voluntary services. On the contrary active local authority support and encouragement stimulated voluntary organisations.