Long-term health and social care for the elderly: An international perspective

This paper describes how industrialized countries have taken different paths towards meeting the needs of their dependent elderly. Dependency-related needs come under the heading of social protection, since they involve general home help and medical care, even if homecare is essentially provided by members of the person's family. Thus, the diversity of medical care and social protection systems, their level, their ` ̀ Bismarckian' ' or ` ̀ Beveridgian' ' nature, has an impact on long-term care systems. We can therefore distinguish three main groups of countries that differ from an institutional point of view. In the future, because of demographic and sociological changes, it seems unlikely that family care could continue to play such an important spontaneous role, especially in the southern European countries. 1