Aged Care Utopias: The Promise and Contradictions of Recent Radical Transformations of Long-Term Support.

The past half century has seen massive and unprecedented changes in the way that care for the increasing numbers of older people needing support is conceptualised and delivered. This is particularly evident in the market societies in which changes in care are the deliberate product of policy shaped by the neo-liberal politics of welfare capitalism. While the process of innovation has both local and global dimensions, the broad outlines of the goals and results are remarkably common: the development of alternatives to family provision and institutional provision; case-management and more integrated and individualised/personalised forms support; and a move away from centrally organised and publicly funded provision towards more flexible funding, which increasingly involves marketized provisions. Yet we also continue to be confronted by the contradictions, failures and shortcomings that are the product of these changes, including the continued devaluing of caregivers, paid and unpaid; the ongoing gender imbalance in responsibility for direct provision; and inequalities in access and outcome. This paper explores the promise of these utopias and their contradictions, through a focus on three distinct socio-analytic perspectives: the political-economy of welfare; the quantitative research dimension; and the precarity of care.