Projects / Programmes
Exploring and understanding welfare state determinants of care provision for older people in the community in Slovenia and Austria
| Code |
Science |
Field |
Subfield |
| 5.03.00 |
Social sciences |
Sociology |
|
| Code |
Science |
Field |
| S215 |
Social sciences |
Social problems and welfare, national insurance |
| Code |
Science |
Field |
| 5.04 |
Social Sciences |
Sociology |
welfare mix; long-term care; community; informal care, family care; formal care; care mix
Researchers (17)
Organisations (2)
Abstract
As the population ages and the demand for long-term care increases, there has been a trend towards familialization of long-term care policies, either by providing state support for families as the main providers of care or by providing very limited support and relying on families by default. The DET_CAREMIX (Exploring and understanding welfare state determinants of care provision for older people in the community in Slovenia and Austria) addresses how the familialization of long-term care affects older people and their families. The overarching research question of DET_CAREMIX is how frail older people residing in the community and their families make choices regarding the care mix (informal vs. formal care or a combination of both) and care tasks in different contexts of long-term care familialization. DET_CAREMIX focuses particularly on differences in the choices people make according to differences in gender, socioeconomic background (e.g. education, income) and access to social networks.
DET_CAREMIX implements a comparative design, using Austria and Slovenia as two dissimilar examples of familialization policies: supported familialization through generous cash benefits in the former case; and familialization by default in the latter case, given the paucity of state support for long-term care. The project uses a mixed methods approach to answer its main research question. It employs quantitative methods, namely multivariate statistical analysis, using the SHARE survey for Slovenia and Austria and data from the first representative survey of providers and users of social home-care services in Slovenia. These are used to inform a subsequent qualitative study based on 55 semi-structured in-depth interviews with older users of care or their families in each country, which are analyzed using framework analysis.
DET_CAREMIX study will make an original contribution to the literature on the familialization of long-term care by providing insights into how different degrees of familialization impact the alternatives available to dependent older people. Finally, DET_CAREMIX will also bridge a gap in knowledge on the factors that impact care mixes and care tasks by analysing differences between groups of older people defined by gender, socioeconomic status, type of community and social network characteristics. This will help advance the nascent literature on inequalities in long-term care use. By contributing to a better understanding of the choices of frail older people and their families, the findings will have direct relevance for policymakers, allowing them to better formulate policies and address inequalities in the use of different types of care.
The multi-disciplinary research team of DET_CAREMIX is led by Dr Valentina Hlebec (Faculty of Social Sciences at the University of Ljubljana) from Slovenia and includes another Slovenian partner institution (the Institute for Economic Research) and an Austrian partner (the European Centre for Social Welfare Policy and Research), whose DET_CAREMIX team is led by Dr Ricardo Rodrigues.
Significance for science
By focusing on specific groups of the elderly population, the findings of this project will go beyond an analysis of care mix and care tasks selection for the older population as a whole, in order to present insights into group differences within and across countries. Such results are all but lacking in the specialized literature and will provide an evidence base for policy discussion on equality and equity in long-term care and for ageing cohorts in general.
In addition, the findings of this project will reflect not only the impact of different public LTC benefits (e.g. cash-for-care benefits), but also the broader regulations impacting intergenerational exchanges. We hypothesize that the interplay between these two is of particular relevance in the context of the familialization of LTC systems, where families play a relevant role as care providers. Furthermore, as we will study the impact of these factors not only on the care mix, but also on care tasks, we will open a new field of inquiry and contribute novel results to the specialized literature.
By including Slovenia as one of its exemplar countries, the project will allow for a country from the Central/Eastern European LTC regime to be analyzed from a comparative perspective. This will extend the geographical coverage of previous studies and will contribute to understanding how Central and Eastern European LTC systems fare in comparison with those in Western and Northern Europe.
Finally, this project will contribute to developing the literature on the sociology of ageing as it relates to care, policies and provisions for older people (Johnson 2005). We will explore the relationships between older people, their informal and formal carers and the care process as it takes place in daily care experience, and we will assess the factors that stimulate/hinder the use of formal and informal care in the specific welfare contexts of Austria and Slovenia. We will also provide insights into the processes through which specific public policies impact the care mix and care tasks. Furthermore, we will work in a comparative research field and look at the position of both countries and their welfare systems among other European countries and welfare systems. We will establish whether the same or different factors influence the care models in different welfare contexts, with an emphasis on comparing Austria and Slovenia. By addressing these points, we will further develop the care models in a European welfare context.
Significance for the country
We believe our project can have a significant impact on the economies and societies of Slovenia and Austria via three core contributions: i) providing an evidence base for key dimensions of the LTC system in order to inform on-going reform processes in both countries; ii) providing more reliable estimates of LTC utilization and the mechanisms that underlie it by drawing on novel, more precise data for Slovenia; and iii) giving a voice to older people and their carers by directly including them in the research and by focusing on their support needs, satisfaction and quality of life. Each is briefly detailed below.
The on-going reform process of the Slovenian LTC system is considering cash-for-care benefits as a way to improve social protection for LTC and develop community care (Rodrigues 2014). Understanding the factors that impact the choice of care mix and care tasks will inform policies aiming at a more efficient use of different forms of LTC and at allowing older people to remain at home.
Owing to extreme fragmentation and lack of cooperation among care systems and the lack of systematic and comparable surveying of information about users, policymakers face severe challenges. The most recent analysis of the long-term care system carried out in Slovenia (Nagode et al. 2014) showed that the system’s official data, which is provided by the Organization for Economic Cooperation and Development (OECD), gave biased and incorrect estimates of the share of users of the long-term care system (OECD 7%, Nagode et al. 12%). This underestimation of the share of users of the long-term care system in Slovenia is a direct consequence of the fragmentation of the long-term care system and the separation of statistics and data gathered from three different systems: health, social protection and retirement. The data we will use in our study, the SHARE survey and the SPUSHC, will help provide a much more accurate picture of the situation in Slovenia, while still allowing for comparability between the two countries.
In this project, we will provide insights into the scope and role of formal care in the long-term care system in Slovenia, and compare this with the situation in Austria. We will emphasize the role of informal care in the system’s design and development, since informal care is mostly ignored by the policymakers. We will establish which barriers are encountered during the care process and how these problems are solved by older people and their informal carers. We expect that, based on this research project, we will be able to provide scientifically sound inputs for forming recommendations for the development of a care system in Slovenia and Austria that will meet the needs of the elderly and their informal caregivers. The final goal of this project is to provide a scientific background for policy development that should result in a better quality of life for older people and their informal carers.
Most important scientific results
Interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
