Abstract
Long-term care (LTC) is one of the most rapidly developing policy areas in Europe, where significant institutional change and innovation have taken place over the last two decades throughout the continent. In contrast to mainstream policy fields (e.g., pensions, labor market policies, and health care), where attempts to reduce public intervention has been the most common trend (Castles, The Future of the Welfare State: Crisis Myths and Crisis Realities, 2004, Policy and Politics, 33(3), 411–430, 2005; Korpi and Palme, American Political Science Review, 97(3), 425–446, 2003; Pierson, The New Politics of the Welfare State, 2001), LTC has seen a broader scope of transformations, ranging from retrenchment and cost containment to a growth in public financing and an expansion of coverage. In many European countries, LTC policies over the last two decades have been characterized by a recognition of social rights on the one hand and yet increasing social responsibilities on the other (Morel, The Politics of Post-Industrial Welfare States, 2006). This book is aimed at describing these general trends, identifying the factors, which explain these broad developments, highlighting both the main differences between European countries and outlining the main consequences of the various policy developments that have taken place.
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Notes
- 1.
We use here a broad definition of LTC, namely, as “a range of services required by persons with a reduced degree of functional capacity, physical or cognitive, and who are consequently dependent for an extended period of time on help with basic activities of daily living (ADL), such as bathing, dressing, eating, getting in and out of bed or chair, moving around and using the bathroom. This personal care component is frequently provided in combination with help with basic medical services such as help with wound dressing, pain management, medication, health monitoring, prevention, rehabilitation or services of palliative care. LTC services can also be combined with lower-level care related to help with instrumental activities of daily living (IADL), such as help with housework, meals, shopping and transportation” (OECD 2011). This definition, however, fails to consider income scarcity, material deprivation, poverty, and housing distress, factors, which are often related to dependency.
- 2.
This is one of the most widespread explanations of change in the social sciences, based on the idea that institutions tend to be path dependent (once a certain institution is set, due to a series of events, it tends to maintain inertia over time and finishes with reinforcing itself with a lock-in effect); only in the case of relevant external shocks (e.g., relevant economic and political crisis) will institutional change take place (Pierson 2001).
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Pavolini, E., Ranci, C. (2013). Reforms in Long-Term Care Policies in EuropeAn:Introduction. In: Ranci, C., Pavolini, E. (eds) Reforms in Long-Term Care Policies in Europe. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4502-9_1
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