Reform strategies in home care for elderly in Europe

The reform of old age care is high on the agenda of countries across Europe. The ageing of societies is increasing the demand for services, while purely family based care arrangements are becoming more unsustainable. Both developments occur in welfare states which have been predominantly been characterised by financial austerity since the late 1970s. These broadly common challenges make it interesting to look more closely at how different European countries with each their care regime have responded. What are the specific drivers for reform and which particular set of actors have pushed for reform? Further, what are the specific strategies for reform? While there is a plethora of single country case studies addressing these types of questions, systematic comparisons across countries are much rarer.

A recent international research project Living Independently at Home (LIVINDHOME) investigated these issues in 9 European countries. This paper presents the comparative findings in analyzing the main reform strategies in home care for the elderly. The paper looks both at the drivers for change and substance of change, in terms the organisation, provision, regulation and quality of care.