Servicio de Información Comunitario sobre Investigación y Desarrollo - CORDIS

Peer reviewed paper: Social exclusion in old age: Challenges for elderly care approaches

The paper provides a new conceptual framework for the evaluation of elderly care. To do so, it combines lines within different research areas. It transfers the concept social exclusion , which has been developed within international comparative welfare state research, to the areas of social-gerontology, sociology on professions and service work. Based on a literature review it investigates, how exclusionary processes in old age in case of care-dependency can be understood. In addition, it defines criteria with regard to elderly care approaches, which should be fulfilled to encounter processes of social exclusion.

The multidimensionality of the concept of social exclusion requires a definition of a multidimensional ageing process, which reveals the different dimensions of ageing and the role of care-dependency. Processes of social exclusion are strongly related to different types of inequality putting women, members of the lower classes and migrants at a disadvantage. The discussion on social exclusion in old age challenges the present approaches of elderly care and makes demands on certain changes. Basically, a comprehensive and integrated care arrangement is necessary including both formal and informal care and universal access to care services on the basis of social rights.

In the course of the article the challenges are discussed within different areas of elderly care in a greater detail. In a first part the issue of access to and freedom of choice between care offers are discussed on the basis of present research findings. The findings reveal that the introduction of the freedom of choice between offers related to the concept of consumerism does not secure access and does not offer a real choice.

The outcomes of the introduction of cash payments are more contradictory, which depends in particular on the level of the payments. The introduction of social rights and corresponding assessment procedures can give the elderly more often fair access to economic support or care services.

However, a wide range of further developments are necessary. In a second part the nexus of formal and informal care are analysed. Since the 1990s the development of care services has inspired scientific research and debate on the combination of formal and informal care. Moreover, the integration of formal and informal care can be viewed as a prerequisite for an integrated and comprehensive care arrangement.

Research findings of empirical studies show that an increase of formal care provision does not result in a withdrawal of the informal carers, but may lead to new forms of cooperation and the definition of new caring-tasks. However, in daily care work obstacles are visible, which impede a cooperation; i.e. the low professional status of the activity and the neglect of the competences and experiences of the informal carers by the formal carers. In sum, the literature review reveals the challenges with regard to the development of elderly care, the obstacles but also the chances.

The paper is going to be published within a referred English-journal, which is read by sociologists doing research within the area of service work or professions. Moreover, this volume is a special issue, which combines welfare state research and service work. In particular, the broad conceptual framework may inspire researchers within the different areas. The conceptual framework is already used for an empirical study within the EU-Project CARMA (compare Del 17).

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