Service Communautaire d'Information sur la Recherche et le Développement - CORDIS

23 NAtional BAckground REports (NABAREs) and a Pan-EUropean BAckground REport (PEUBARE, based on 23 national reports)

The 23 NAtional BAckground REports (NABAREs) and the Pan-European Background Report (PEUBARE) focus on family carers of older people and their situation in Europe, considering how services do and do not help those who provide a vast amount of care and support at a family and informal level. The NABAREs in particular deliver an often-unprecedented overview for each of the 23 countries involved in the project, thus acting as a relevant stimulus to those involved in issues related to care.

The PEUBARE, on turn, has re-assessed the country specific findings and suggestions in a cross-national context, thus providing to family carers, policy makers and service providers updated knowledge and new ideas about how best to move forward in supporting both family carers and older dependent people, a topic which at the EU level has being increasingly recognised as a significant issue, related as it is to the three keystones of accessibility, quality and sustainability of health care systems, to social inclusion and to employment.

The structure of the reports takes into account the fact that, in all EU countries, the responsibility for the provision of and payment for long-term care is divided between four sectors: family and informal care sector; state or public sector; voluntary and non-governmental-organisation (NGO) sector; care market or private sector. The balance of care provision in each country depends on a mixture of factors such as tradition, legal responsibilities, health and social policy, national budgets and national wealth and, last but not least, demographic trends regarding fertility levels and life expectancy, which affect the availability of informal family carers. There are substantive differences between countries in Europe as to how care is provided. Those with poorly funded welfare states and a continuing association between poverty and old age are associated with low service provision limited to those who can pay or who lack alternative sources of care, whereas in those countries with very high taxation demand for services as a taxpayer’s right is high.

However, since demand is potentially infinite, even countries which provide services as a citizen’s right inevitably have to introduce a system of rationing, usually based on needs assessment (objective assessment of need for a service) and means testing (income and assets assessment of the older people and/or family carers) to ascertain the older person’s ability to make a financial contribution to payment for care. The former Communist regimes with their previous welfare infrastructures are gradually being reconstructed with a plurality of partners from state, local authority, NGOs and private sectors.

Despite wide variations in systems of formal care provision for dependent older people, in all the 23 EUROFAMCARE countries the vast majority of care is provided informally by individual family members. Even in countries such as Sweden, where the state has traditionally been a main provider of care, the need to contain increasing costs, in combination with the stated preferences of older people themselves to remain in their home environment for as long as possible, has led to what has been described as a re-discovery of family care.

The NABARES make available systematic and comparable data on the national situations of family carers, based on a Standardized Evaluation Protocol, to facilitate the cross-national analysis used for the production of the PEUBARE. The lack of data on family carers in many countries and the wide variation on how available data are recorded does however not always allow comparing findings between countries. Despite these difficulties, several key aspects relating to the family care of dependent older people recurred in most reports and allow to draw some enlightening conclusions on the present state of family care across Europe, with a view to making recommendations for future policy for the support of family carers at both national and EU levels.

There are strong indications that family carers will continue to provide the bulk of care in the foreseeable future, so one of the main themes of the report are the different methods of supporting family in choosing what aspects of care to provide, enabling them to care without damage to their own well-being and to avoid long term poverty.

The short and long term outcomes and impact of the different types of support for the well-being of older people and family carers, as well as for national and EU economies, are also referred to, and 8 matrices have been developed as a way of analysing the large amount of national data, on following topics: legal position of family carers and recognition by the state; labour force, informal and formal; home-based services for older people; services for the support of family carers; residential care; current policy debates; recommendations and future research needs; other issues.

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