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From the state to the family or to the market?: Consequences of reduced residential eldercare in Sweden
Stockholm University, Faculty of Social Sciences, Department of Social Work. (Omsorgsforskargruppen)
Stockholm University, Faculty of Social Sciences, Department of Social Work.
2015 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 24, no 1, 81-92 p.Article in journal (Refereed) Published
Abstract [en]

This article analyses the changing roles of the state, family and market in providing care for older people in Sweden, in relation to Scandinavian welfare ideals of universalism and de-familisation. Since 2000 every fourth residential care bed has disappeared and the increase in homecare services has not compensated for the decline. Instead family care (defined here as help from adult children and other non-cohabiting family or friends) has increased in all social groups: help by daughters mainly among older people with shorter education and help by sons among those highly educated. Use of privately purchased services has also increased but continues to play a marginal role. Family care remains more common among older people with less education whereas privately purchased services are more common among those with higher education. This dualisation of care challenges universalism, and working-class daughters continue to be most affected by eldercare cutbacks.

Place, publisher, year, edition, pages
2015. Vol. 24, no 1, 81-92 p.
Keyword [en]
eldercare, family care, Sweden, privately purchased services, socioeconomic differences, gender, de-familisation, re-familisation
National Category
Social Work
Research subject
Social Work
Identifiers
URN: urn:nbn:se:su:diva-109645DOI: 10.1111/ijsw.12108ISI: 000346912200009OAI: oai:DiVA.org:su-109645DiVA: diva2:766155
Available from: 2014-11-26 Created: 2014-11-26 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Omsorgens pris i åtstramningstid: Anhörigomsorg för äldre ur ett könsperspektiv
Open this publication in new window or tab >>Omsorgens pris i åtstramningstid: Anhörigomsorg för äldre ur ett könsperspektiv
2015 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
The cost of caring in the Swedish welfare state : Feminist perspectives on family care for older people
Abstract [en]

This thesis examines the extent of family care for older people, primarily filial care, and the costs of caring in the Swedish welfare state. Costs of caring are understood as the negative effects of caregiving, primarily on the caregivers’ working life. The analysis is inspired by feminist theories on the importance of welfare state provisions for care for women’s citizenship, including personal autonomy and economic independence.

The main aims of this thesis are twofold. The first is to explore the extent and development of family care for older persons in Sweden, primarily filial care, and the consequences of caregiving for well-being and working life. The second is to explore how older persons’ family members have been represented and the possible consequences of these representations for the development of publicly financed eldercare services and other forms of support for family carers, as well as for family members’ living conditions.

The thesis consists of four studies. The first reviews the literature concerning the extent and consequences of family caregiving for older persons and the welfare state’s policy responses to older people’s care needs. The second study analyses how older persons’ family members and their role in eldercare have been represented in Swedish eldercare policy since the 1950s. The third study analyses surveys to explore changes during the 2000s in the role of the family, the public sector and the market in providing care for older persons in Sweden. The fourth study is a survey analysis of the extent, content and consequences of filial care among middle-aged women and men in Sweden in 2013.

The policy analysis found that the expansion of eldercare was motivated solely in relation to older persons’ needs; thus working daughters’ needs of eldercare have been a blind spot in Swedish eldercare policy.

Since 2000, every fourth residential care bed has disappeared and the increase in homecare services did not fully compensate for the decline, resulting in a significant increase in filial care in all social groups, and among both sons and daughters. Daughters of older persons with shorter education, however, remained the primary providers of filial care.

Both daughters and sons are affected by caregiving. They suffer to the same extent from difficulties in managing to accomplish their work tasks and taking part in meetings, courses and travels. They are also equally likely to reduce their working hours and to quit their job. It is however clearly more common that daughters experience mental and physical strain, difficulties in finding time for leisure and reduced ability to focus on their job. Although more daughters than sons retire earlier than planned due to filial care, this is very rare.

Managerial care (handling contacts with health and eldercare services) has a more salient role in a welfare state such as Sweden, with generously provided care services, less intense filial care and high employment rates among both sexes. The high labour force participation however makes middle aged children more vulnerable when their parents’ care arrangement does not work. The decline in eldercare services since 1980 has reinforced co-ordination problems in health and eldercare services. The managerial care required to handle this development, while living up to the demands of work and family life, stands out as especially demanding for the well-being and working lives of daughters.

Place, publisher, year, edition, pages
Stockholm: Institutionen för socialt arbete, Stockholms universitet, 2015
Series
Rapport i socialt arbete, ISSN 0281-6288 ; 150
Keyword
family care, filial care, older people, eldercare, gender, cost of caring, social policy, care services, de-familialization, re-familialization, universalism, Swedish welfare state
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-121477 (URN)978-91-7649-266-6 (ISBN)
Public defence
2015-11-06, Aula Svea, Socialhögskolan, Sveavägen 160, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Accepted.

Available from: 2015-10-15 Created: 2015-10-05 Last updated: 2015-10-09Bibliographically approved

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