Abstract

Background: Since the 1990s welfare state policies towards long-term care (LTC) for older people in need of care have experienced fundamental reforms in many countries. Most European welfare states have introduced new social rights and extended the infrastructure based on publicly funded care provision for older people. However, many welfare states have also introduced pay and elements of social security for caring family members.

Objectives: This article explores in how far the concept of de-familialisation/familialisation is still adequate to the classification of LTC policies for older people. In the theoretical debate over LTC policies, de-familialising and familialising policies are often treated as opposites. We propose to re-conceptualise the relationship between de-familialisation and familialisation. We argue that they represent substantially different types of policy that theoretically vary relatively autonomously. In order to evaluate this theoretical assumption, this article investigates the relation between the generosity level of LTC policies regarding extra-familial care and paid family care. It is also analysed how different combinations of LTC policies effect gender equality.

Methods: The article is based on a cross-national empirical study that analyses the generosity of LTC policies regarding extra-familial care and paid family care separately and in their interplay, as well as the consequences of different combinations of LTC policies for gender equality with regard to the relationship between labour force participation and family care (in brief, “the work-care relationship”). It introduces a new multi-dimensional approach to measuring the generosity of LTC policy for older persons directly at the institutional level of the regulations on extra-familial and paid family care. For the comparative analysis, five European welfare states are included from different parts of Europe that show significant differences regarding their welfare state tradition. They comprise Denmark, Germany, the Czech Republic, Italy and Ireland. The paper uses analysis of documents about care policy legislation, data from MISSOC (Mutual Information System on Social Protection), European Quality of Life Survey (EQLS) and OECD Labour Force Statistics.

Results: The findings support the argument that de-familialising and familialising care policies theoretically vary relatively independently of each other. It turns out that we get a better understanding about the relationship between LTC policy and gender equality if we analyse the role of different combinations between extra-familial and familial care policies for gender equality. The policy implications of the analysis suggest that welfare states that combine generous LTC policy regarding extra-familial and familial care will promote gender equality the strongest by offering family members both the option not to care, based on generous extra-familial services, as well as generous financial and social security for persons who wish to care for their relatives.

Conclusion: The paper brings new insights into the ways welfare states act in regard to their care policies. It helps to clarify how the concept of de-familialisation/familialisation can be understood, and what this means for the relationship between care policies and gender equality.