Health and Mortality among Elderly Populations

By Graziella Caselli; Alan D. Lopez | Go to book overview

15 Formal and Informal Care: New Approaches

SVEIN OLAV DAATLAND


15.1. Introduction

However differently the modern nations have organized their ageing policies, they seem to have the following problem in common: while needs are increasing, the resources to accommodate these needs are diminishing, at least in a relative sense. And while earlier the increased needs could be coped with because of economic growth, the joint occurrence of continued ageing and an economic recession indicates that the needs-resource gap will expand.

There is probably widespread agreement about this diagnosis in all its generality, but far less agreement about the specifics of the problem, and above all, about what should be the solution. Some features of both problems and solution are more or less universal, while others are local, and nation- specific. Generally speaking, the resource gap is the result of too large demands and/or too scarce resources, and the gap may in principle be bridged from either side. We may moderate demands directly, and/or redirect them towards other sources, or we may increase resources, and/or rearrange them in order to use them more effectively.

This chapter will start by looking more closely at the factors and mechanisms which produce increased demands on resources, and in so doing will discuss the possibility and desirability of moderating the impact of these variables. We then turn to the resources: how services are organized, what changes may be observed, and what changes are called for in light of the future challenges. The Scandinavian case will be used as an example, and we will then discuss to what extent the Scandinavian experience may be generalized to other contexts. The discussion will concentrate on care and services to the elderly, although pensions and other forms of cash transfer constitute the major part of the budgets for ageing policies.


15.2. Increasing Demands: Factors and Mechanisms

The most obvious factor is demographic change: the sheer and simple increase in the number of old people, in particular the very old, both in actual numbers

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