Elderly Care in Changing Societies: Concurrences in Divergent Care Regimes. a Comparison of Germany, Sweden and Italy

The European countries are facing social changes that are challenging their long-term care (LTC) systems in different ways. Ageing populations and a decrease in the care potential in families have led to different paths of modification of traditional care regime organization. The paper compares the LTC policies of Sweden, Germany and Italy, three countries that have traditionally been regarded as representatives of distinct care regime types. The interrelation between policy reforms, changing public support, patterns of care arrangements and the commodification of care work are compared among the three countries. The analysis aims to reveal the basic dimensions of (changing) LTC policies and their effects in these countries, trends of convergence and divergence among the three regimes, and the main characteristics of the changed care regimes. The own conceptual framework combines different approaches developed within the area of international comparative research on long-term care respectively on welfare state and the area of professionalisation. Empirically, it is based on national representative statistics, an analysis of the institutional design of policy schemes and a literature review. Despite a trend of convergence characterized by redefined involvement and a complex mixture of state, market and family resulting in an increased employment of migrant care workers and precarisation of care labour the countries analysed still represent different care models. In particular, public efforts, the emphasis on family care versus professional services, and the role of different state levels in the governing system and reform paths are the key elements that distinguish national LTC organization.