Care in ageing and diversifying societies

An overarching question is how the Nordic systems of service provision respond to demographic ageing and diversification. What is the net effect of improved elderly people´s health, more "old-old" people (80+) and more one-person households on the demand for care services? Are increasing dependency rates, rising costs of care services, preference diversification and promises about user-choice shifting the Nordic service packages towards non-public provision, consumer-citizenship (based on vouchers or cash-for-care) and/or individual, family or third sector provision? If so, how will such shifts affect gendered divisions of labour in families and paid work? Is offloading of tasks from public eldercare to the family more prominent in some Nordic countries than others?

Will private health and care insurance become significant in the Nordic countries? Are non-western female immigrants becoming the main workforce in care services (home helpers, nursing home staff)? What forms of governance and regulation develop in the emerging public-private care regimes of Nordic countries? Do these countries find different balances between the competing pressures towards decentralisation, devolution and deregulation (centrifugal forces) vs. pressures towards state regulation and control (centripetal forces)? What accountability policy develops within the new public-private care regimes? What images of accountability gain hegemony and which images are marginalised? How does the development in care provision affect the legitimacy of the NWM?

Leader: Marta Szebehely
Professor, Stockholm University
E-mail: marta.szebehely(a)socarb.su.se, Phone: +46 8 674 73 94

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The overarching aim of REASSESS is to analyse the development of the Nordic Welfare Model (NWM) in different Nordic countries with a focus on institutional changes and the potential of renewal and sustainability of the NWM. REASSESS is guided by an ambition to focus on different combinations of institutions, rather than on one particular institution, and to be sensitive to the particularities of different national policy constellations. Hence REASSESS will not only address single issues or policies, but aim for a better understanding of the intended and unintended consequences of policy changes, as they, taken together, manifest themselves in the everyday lives of women and men, i.e. how people in the Nordic countries live the consequences of changing public policies.

In line with this general aim of REASSESS, the aim of the strand ‘Care in ageing and diversifying societies’ is to analyse the present trends in care for older people in the Nordic countries, with a focus on institutional changes as well as on the consequences of these changes - for people’s everyday lives and for the legitimacy/sustainability of the NWM.

In terms of resource allocation and coverage of public care services the Nordic countries have developed in different directions. The details need to be clarified, but at least until recently there has been a decline in the coverage in particular in Finland and Sweden. How can these diverging trends be explained? What is the role of national policies (financing, legislation) and of municipal policies (financing, organising of services, local guidelines)? Are there different and changing norms and expectations among different groups of older people and their families? How does the actual organisation and quality of services affect their demands/preferences?

How is care of older people in the Nordic countries divided between family, state, market and the voluntary sector? Is there a shift towards more market involvement in care provision and/or individual, family or voluntary sector provision?  Is offloading of tasks from public services to the family and/or to privately purchased market services more prominent in some Nordic countries than others? If so, how do such shifts affect gendered divisions of labour in families and paid work? Are there class and ethnicity patterns in this context?

How have the Nordic welfare states responded to the challenges caused by demographic ageing, diversification, and by the cross-border diffusion of market inspired remodelling ideas (NPM)? What elements of NPM have affected eldercare policies in the different Nordic countries? Are private care insurances becoming significant in the Nordic countries?

How is the organisation of publicly financed care services changing? Are the Nordic countries facing similar challenges in recruiting and keeping care workers? Do the care workers experience similar working conditions? What is the role of non-western immigrants in the publicly financed care services and in a privately financed, unregulated care market? What forms of governance and regulation develop in the emerging public-private care regimes of Nordic countries?