Old-Age Care Provision in Spain in the Context of a New System of Long-Term Care and a Lingering Economic Crisis

Abstract

This study analyses whether care providing strategies for non-institutionalized older adults have changed in the context of a new system of long-term care that emanated from the 2006 "Dependency Act", and a lingering economic crisis. The Spanish sample of the Survey of Health, Ageing and Retirement in Europe (waves 2006 and 2013) is employed to analyse how different individual and household factors affect care strategies, distinguishing between informal (co-resident and non-resident) carers, formal carers and combined formal and informal care, using descriptive statistics and multinomial logit regression. Results show that availability, co-residence and the proximity of children are the main determinants of informal care provision to elders in need. Some externalization of informal care from the domestic domain also took place between 2006 and 2013 as well as an increase in multiplecare arrangements. In the discussion, we comment on why the new Spanish care system that was developed during the economic boom but implemented during the bust years may have consolidated informal care through the economic compensation of mainly family carers. Future research should investigate whether the increase in combined formal and informal care is because of preferences of potential family caregivers or due to a lack of alternatives.

Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain

“…In this sense, a recent , so we cannot expect the magnitude of the impact if DA had not been implemented in 2007. This could also suggest that the spouses, the principal informal caregivers, are receiving social service help and other workers who previously did not receive [62]. According to the literature, there is no an optimal relationship between formal and informal care equivalent for all people [63][64][65].…”

Technological Solutions and Informal Care Culture for the Elderly: An Intervention Proposal for Training Actions

“…The "familist" model of care in Spain is perpetuated by the need for solidarity within the family because institutional developments for long-term care do not cover the real needs of an increasingly aging population [8,21,30]. In this regard, several authors agree that the precarious implementation of the LAPAD 2 , resulting from the economic crisis of 2008, had as one of its consequences in the continued informal employment of caregivers, especially women [14,19,30]. This Law brought substantial improvements to the situation of people who were engaged in long-term care of the elderly, by decisively assuming the responsibility of the State in this type of care [19], which should have led to a broad professional regulation in the sector.…”

“…This Law brought substantial improvements to the situation of people who were engaged in long-term care of the elderly, by decisively assuming the responsibility of the State in this type of care [19], which should have led to a broad professional regulation in the sector. However, the severe funding problems caused by the economic crisis of 2008 made it impossible to properly implement the benefits and services outlined in the Law [30], resulting a highly unstable sector with a high level of precariousness among its workers [5]. Thus, although there have been notable advances, thanks to the LAPAD, the institutional setting in charge of caring for the elderly is precarious, and this work will be carried out on numerous occasions by the family environment in conditions of informality [30].…”

“…However, the severe funding problems caused by the economic crisis of 2008 made it impossible to properly implement the benefits and services outlined in the Law [30], resulting a highly unstable sector with a high level of precariousness among its workers [5]. Thus, although there have been notable advances, thanks to the LAPAD, the institutional setting in charge of caring for the elderly is precarious, and this work will be carried out on numerous occasions by the family environment in conditions of informality [30].…”

Role of Private Long-Term Care Insurance in Financial Sustainability for an Aging Society

“…Depending on the welfare state characteristics of each country, the problems derived from financing dependency public coverage are acute and contribute differently to the development of dependency private coverage [23,24]. In the literature, we find several theoretical proposals combining LTC and retirement pensions in the public system.…”