Community care for older people1996

Caring for frail older people is a major social policy issue for the late 1990s and beyond. One of the crucial challenges faced by contemporary industrial societies is how to devise appropriate responses to the needs of their ageing populations. Reforms are being implemented in Europe and North America to address the key issues of providing and paying for long-term care. At the same time, students, policymakers, service providers, practitioners and social policy analysts all need background knowledge of the systems and cultures of social and welfare service provision in other industrial societies. Community Care for Older People provides such information in accessible form through a clearly developed framework for the comparison of policies, processes and outcomes. Taking a wide definition of community care, the author explores the origins of policies on pensions and the financing of care, housing, health and welfare services, education and leisure for older people. She compares illuminatingly the ways in which such services are provided and funded in six countries that differ in policies, systems and the balance of the welfare mix. Identifying the key changes in the patterns of services, she finds that successful outcomes of community care are unevenly distributed, that services are underprovided, that individuals and families are bearing greater responsibilities and costs of care, and that inequalities between social groups in access to care have increased. Community Care for Older People concludes that a shift in the balance of political priorities in favour of humanitarian rather than economic aims of community care is needed if integrated care for older people and carers is to be resourced and implemented effectively.