Sociology
The chapter surveys the main themes of the case studies in the volume, stressing how much these otherwise diverse nations have in common in their approach to elder care. In all cases it has never taken priority in policy-making compared with other welfare issues. Discrimination and stereotyping of older people have been pervasive. Everywhere female family members have taken the main responsibility for care, with little public support. The pressure upon them has grown, often stressfully, as care services, public and private, have declined further with the spread of neoliberalism and the still greater impact of the COVID pandemic. This has generally made the inadequacies of care more public but there is little sign that it is leading to improvement anywhere.
Like other Mediterranean countries, Portugal is characterised by a strongly familistic care regime, where women continue to play a central role in family care. Recently, Portugal has attempted to implement the Informal Carer Statute, a policy to support family carers. This chapter aims to chronologically reconstruct the evolution of the carers’ policy in Portugal and identify controversies around this social policy. Based on a documental and historical analysis, 15 regulations were identified between 2016 and 2022, focusing on the benefits for informal carers, cash benefits, and state co-payment of services. Eligibility criteria, based exclusively on income, limit the access of thousands of carers who are silenced by the state. The new care regulation has exclusively become a measure to combat situations of poverty. Recognition of the carer's contribution and protection in retirement and ill-health have been minimised, although these constituted one of the main demands that pushed for the emergence of a carers' movement in the public arena. The struggle for recognition through the social movement for informal carers (O movimento dos cuidadores informais) turned into a struggle to change the law, mobilising civil society. The National Association of Informal Carers, as the representative body of its members, emerged from the social movement and, recently, was the promoter of a citizens' legislative initiative. Through the Portuguese case, different examples of strategies of a process of politicisation are portrayed. Care becomes thus an object of political struggle within the social and political field.
This chapter introduces the topic of care for older people as inherently political and gendered and the related politicising and gendering processes in Europe. First, it presents the epistemological and academic motivations underpinning the need to elaborate a multidisciplinary collective volume on a topic that has not been tackled and developed previously. One of the most important reasons informing this choice is that both politicising and gendering care for older people are two transversal processes that share the same reference to some inherent and pervasive features of care, namely care as political and gendered by definition. Second, the chapter introduces a conceptual background indispensable to establishing a clearly defined focus of all contributions to the book. Neither exhaustive nor providing a deductive approach or theoretical framework shared by all chapters, this conceptual background concerning politicising and gendering care for older people in Europe serves as a reference tool guiding different country-based and multi-level analyses. Its primary role is to introduce one clearly outlined exploration interest while opening up diverse research questions and multidisciplinary studies. Third, the introductory chapter presents the book’s structure and the topics, questions, and research directions addressed by each contribution to the volume. These multidisciplinary investigations depend primarily on the specific and relevant aspects concerning politicising and gendering care for older people and how these occur in different European settings and at societal and political levels.
The COVID-19 pandemic has had a significant impact on the care of older adults in Serbia. Under the guise of care for ‘grandpas and grandmas’, the government enforced policies, measures, and protocols that severely impacted the already fragile system for the care of older adults in Serbia, at the same time creating a situation in which those older persons who were previously independent turned completely dependent, while those who were truly in need of care were unable to get it. On the other hand, the underpaid, undervalued caregivers – the main subjects of this chapter – bore the greatest brunt of the pandemic-induced politicisation of care for older adults in Serbia. Prior to the pandemic, care of older adults was already a gendered issue, as women were the primary providers of both informal and formal care. The pandemic has exacerbated this gender imbalance. In addition, the pandemic has shed light on the shortage of skilled caregivers and the precarious position of paid care in the informal economy. The shortage of caregivers has made it even more difficult for women to balance their paid and unpaid work, and it has also led to a decline in the quality of care for older adults.
Care has traditionally been considered as belonging to the nation-state and the family, where the EU as an institution has not interfered. However, since 2017, old age care has been a right according to §18 of the European Pillar of Social Rights, and in 2022, the EU launched an ambitious new care strategy covering older, fragile persons. This chapter investigates how the political problem of old age and care for fragile, older people is understood in the EU and the needs identified through a feminist discursive policy analysis. Our analysis focuses on problematisation, care needs, intersectionality, and silencing. It identifies how the greying of the population and old age care have been politicised and have emerged as a new policy field within the EU. It poses the following research question: In what way has ageing and care for older, fragile people been framed as a political problem in EU policy papers? The material from 2013–2022 is read and analysed through a systematic discourse analysis. The empirical material consists of policy papers and reports by the European Commission, Council of the European Union, and European Parliament. We identify a polyphonic discourse that includes feminist elements and gender stereotypes, as well as silencing. It applies neoliberal rationales with paternalistic elements.
Care for older people is conceived as a new social risk and a rising issue for contemporary welfare states. In Croatia, unmet and growing needs for care and limited state capacities for the provision of care for older people have opened space for private (profit and non-profit) initiatives in service provision, which by now outnumber public providers. The chapter analyses recent policy and institutional changes in care for older people in Croatia. It specifically focuses on the role of the private not-for-profit and profit sector in the provision of care for older persons (institutional and in-home care), and their relations with the government and public service providers, using the welfare mix as a conceptual and theoretical framework. Characteristics of the welfare mix model are explored from two key perspectives: financing (changes in responsibility for financing services, trends of marketisation, the structure of financing), and service provision (trends regarding the composition of providers: state – profit – non-profit, types of services, deinstitutionalisation, quality of services, etc.). Older people’s care has characteristics of mixed financing, combining financing from public sources (state budget) and private sources (out of pocket). Accessibility and affordability of services differ between private and public service providers. Growing unmet needs and limited capacities in public institutional care have resulted in marketisation trends. The need for changes in the system of older care services in Croatia is evident. However, this area is not a focus of policy. Different social groups at times try to politicise these issues, but without much success.
In Slovenia, care for older people and its gendered consequences entered the policy agenda and public discussion within the framework of 20-year-long political struggles for policy regulation of long-term care. The chapter analyses the implications of the three core care services, i.e. institutional care, family care, and cash benefit, offered to older people by the Long-Term Care Act finally adopted in 2021. In their analysis, the authors use three key concepts, namely (de)familisation, (de)institutionalisation, and public provision, which in the Act’s preliminary assessment are recognised as relevant to the impact of long-term care on the position of women and gender equality. However, the analysis shows that the legislator does not translate this preliminary recognition into concrete policy measures but formulates concrete policy solutions in a way that is controversial in relation to the principles of deinstitutionalisation, defamilisation, and the establishment of a formal, public network of services. In this way, the Long-Term Care Act raises several new dilemmas and opens the way to problematic developments such as informal, low-paid family or (grey) market care, domestication of women, expansion of precarious forms of care work, pressure to lower wages, and deprofessionalisation. The authors see the reasons for such outcomes in the tensions and contradictions that are inherent to each form of organisation of care, which represents an arena where the conflicting aspirations of different actors collide, and call for open discussion in a broad public debate.
This book offers a new analytical framework for the multi-layered processes of politicising and gendering care for older people, understood as an inherently political and gendered condition of human existence. It brings together contributions that focus on different manifestations and interpretations of these processes in several European settings and at various societal and political levels. It investigates how care for older adults varies across time and place and aims to provide an in-depth comprehension of how it becomes an arena of political struggle and the object of public policy and political intervention. The book comprises multidisciplinary research stemming from gender studies, history, political science, public policy, social anthropology, social work, and sociology. These analyses examine the issue of care for older people as a political concern from many angles, such as problematising care needs, long-term care policies, home care services, institutional services, and family care. The book’s contributions reveal the diversity of situations in which the processes of politicising and gendering care for older adults overlap, contradict, or reinforce each other while leading to increased gender (in)equalities on different levels – familial, professional, and societal. Both caring for older adults or being taken care of when becoming old(er) or frail are potentially a feature of any personal trajectory, which is always contextually situated. Therefore, this book is an invitation to reflect upon care for older people as an issue particularly significant at any time and relevant at any societal level or socio-political sphere.
Ageing population, public expenditure cuts, privatisation of public services, economic migration, and scarcity of personnel in specialised institutions embody some of the most recent challenges that the Romanian system providing care to older people has had to deal with lately. Some aspects are symptomatic of a wider, global or regional phenomenon, while others seem specific to the Romanian context. By assuming that policies should result from public debates and consultations, a process generally called politicisation, this chapter questions various implications of politicising older people’s care. Thus, we focus, on one side, on the defining aspects of the older persons’ care system in Romania and, on the other, on the National Council of Pensioners’ and Older Persons’ Organisations (NCPOPO) as an agency for politicisation. Our analysis privileges an institutional approach, in which primary sources such as legislation, reports, and pieces of information from official websites, as well as secondary literature on older categories’ care in Romania, are equally relevant. Despite recent improvements, we argue that long-term care for older people in Romania keeps being challenged by formal-informal, public-private dichotomies related to care and gender-specific issues – care drain, low salaries, and family dynamics. In this specific context, NCPOPO plays multiple vital roles. Through a diverse repertory of actions, it simultaneously acts as a mediator, negotiator, generator of knowledge, and knowledge diffusion agent that seeks to make older people’s care a topic of politicisation.
Like a growing number of countries around the world, Spain is experiencing a care crisis. This crisis is materialising in the breakdown of the traditional system of organisation and distribution of care work, generating enormous difficulties in providing and receiving care, and exposing the seams of gender and racial inequality that run through the care system. This chapter presents an analysis of long-term care policies in Spain over the last two decades following an approach that considers, in addition to policies, the social practices and discourses surrounding these policies. Special attention is paid to the main initiative developed in this respect in 2006 (Law 39/2006), as well as to the new challenges and policy discourses that have emerged as a result of the impact of the global pandemic. It is pointed out how the double anchoring of Spanish familism, structurally based on the elements of sexual division of labour and ideological preference for family care, has prevented and delayed the politicisation of the issue of care, and also encouraged the use of migrant women’s labour, leading to the development of global care chains. This contribution is framed within a critical social policy analysis that takes into special consideration the particular way in which gender and racial inequalities are articulated in the discourses that are conveyed when addressing issues related to long-term care policies.