Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T05:35:41.707Z Has data issue: false hasContentIssue false

The Return of the Family? Welfare State Retrenchment and Client Autonomy in Long-Term Care

Published online by Cambridge University Press:  04 July 2012

ELLEN GROOTEGOED
Affiliation:
Amsterdam Institute for Social Science Research, University of Amsterdam Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands email: [email protected]
DIANA VAN DIJK
Affiliation:
Centre for Social Policy Studies, City of Rotterdam. email: [email protected]

Abstract

European welfare states are cutting back their responsibilities for long-term care, emphasising ‘self-reliance’ and replacing care as an entitlement of citizenship with targeted services. But we do not know how former long-term care recipients cope with retrenchment and if they are able to negotiate support from their family and friends. Through an analysis of 500 telephone interviews and thirty face-to-face interviews with long-term care recipients facing reduced care rights in the Netherlands, we found that disabled and elderly persons resist increased dependence on their personal networks. Most clients who face reduced access to public long-term care do not seek alternative help despite their perceived need for it, and feel trapped between the policy definition of self-reliance and their own ideals of autonomy.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alcock, P. (2010), ‘Big society or civil society? A new policy environment for the third sector’, www.tsrc.ac.uk/LinkClick.aspx?fileticket=PwhvBXnPGAU%3D&tabid=716 [accessed July 2010].CrossRefGoogle Scholar
Barnes, C. (1998), ‘The social model of disability: a sociological phenomenon ignored by sociologists?’, in Shakespeare, T. (ed.), The Disability Reader: Social Science Perspectives, London: Cassell, pp. 6578.Google Scholar
Boer, A. de and Keuzenkamp, S. (2009), Vrouwen, mannen en mantelzorg: Beelden en feiten, The Hague: Sociaal Cultureel Planbureau.Google Scholar
Bowling, A. (2007), ‘Quality of life in older age: what older people say’, in Mollenkopf, H. and Walder, A. (eds.), Quality of Life in Old Age, Dordrecht: Springer, pp. 1530.CrossRefGoogle Scholar
Boyle, G. (2008), ‘Autonomy in long-term care: a need, a right or a luxury?’, Disability & Society, 23: 4, 299310.CrossRefGoogle Scholar
CIZ (Centrum Indicatiestelling Zorg) and HHM (2008), Onderzoek effecten pakketmaatregelen AWBZ, Driebergen and Enschede: HHM.Google Scholar
Comas-Herrera, A., Wittenberg, R., Costa-Font, J., Gori, C., Di Maio, A., Concepcio, P., Pickard, L., Pozzi, A. and Rothgang, H. (2006), ‘Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom’, Ageing & Society, 26: 285302.CrossRefGoogle Scholar
Cox, R. H. (1998), ‘The consequences of welfare reform: how conceptions of social rights are changing’, Journal of Social Policy, 27: 10, 116.CrossRefGoogle Scholar
Daatland, S. O. and Herlofson, K. (2003), ‘Families and welfare states in elder care: are services substituting or complementing the family?’, in Lowenstein, A. and Ogg, J. (eds.), OASIS Final Report, Haifa: University of Haifa, pp. 285308.Google Scholar
Elias, N. (1987), Die Gesellschaft der Individuen, Frankfurt am Main: Suhrkamp.Google Scholar
Eggink, E., Pommer, E. and Woittiez, I. (2008), De ontwikkeling van AWBZ-uitgaven: Een analyse van awbz-uitgaven 1985–2005 en een raming van de uitgaven voor verpleging en verzorging 2005–2030, The Hague: Sociaal Cultureel Planbureau.Google Scholar
Finch, J. and Mason, J. (1993), Negotiating Family Responsibilities, London and New York: Routledge.Google Scholar
Fine, M. and Glendinning, C. (2005), ‘Dependence, independence or inter-dependence? Revisiting the concepts of “care” and “dependency”’, Ageing & Society, 25: 4, 601–21.CrossRefGoogle Scholar
Galvin, R. (2004), ‘Challenging the need for gratitude: comparisons between paid and unpaid care for disabled people’, Journal of Sociology, 40: 2, 137–55.CrossRefGoogle Scholar
Gilbert, N. (2004), Transformation of the Welfare State: The Silent Surrender of Public Responsibility, Oxford and New York: Oxford University Press.Google Scholar
Glendinning, C. and Wilde, A. (2011), ‘Home care in England’, in Rostgaard, T. (ed.), Livindhome – Living Independently at Home: Reforms in Home Care in 9 European Countries, Copenhagen: SFI, pp. 95116.Google Scholar
Grootegoed, E., Knijn, T. and Da Roit, B. (2010), ‘Relatives as paid care-givers: how family carers experience payments for care’, Ageing & Society, 30: 3, 467–89.CrossRefGoogle Scholar
Jordan, J. (2010), ‘Health care politics in the age of retrenchment’, Journal of Social Policy, 40: 1, 113–34.CrossRefGoogle Scholar
Kaaij, R. and Huijsman, R. (2008), ‘Dubbele winst’, ZorgVisie, 38: 11, 40–3.Google Scholar
Kittay, E. F. (1999), Love's Labor: Essays on Women, Equality and Dependency, New York: Routledge.Google Scholar
Kisby, B. (2010), ‘The Big Society: power to the people?’, The Political Quarterly, 81: 4, 484–91.CrossRefGoogle Scholar
Kremer, M. (2006), ‘Consumers in charge of care: the Dutch Personal Budget and its impact on the market, professionals and the family’, European Societies, 8: 3, 385401.CrossRefGoogle Scholar
Linders, L. (2010), De betekenis van nabijheid, The Hague: Sdu Uitgevers.Google Scholar
Mackenzie, C. and Stoljar, N. (2000), Relational Autonomy: Feminist Perspectives on Autonomy, Agency and the Social Self, Oxford: Oxford University Press.CrossRefGoogle Scholar
Mol, A. (2006), De logica van het zorgen: Actieve patiënten en de grenzen van het kiezen, Amsterdam: Van Gennep.Google Scholar
Muenz, R. (2007), Aging and Demographic Change in European Societies: Main Trends and Alternative Policy Options, Social Protection Discussion Paper 0703, Washington: The World Bank.Google Scholar
OECD, Organisation for Economic Co-operation and Development (2011), Sizing up the Challenge Ahead: Future Demographic Trends and Long-Term Care Costs, www.oecd.org/dataoecd/51/46/47884543.pdf [accessed February 2012].Google Scholar
Oliver, M. (1996), Understanding Disability: From Theory to Practice, London: Macmillan.CrossRefGoogle Scholar
Pavolini, E. and Ranci, C. (2008), ‘Restructuring the welfare state: reforms in long-term care in Western European countries’, Journal of European Social Policy, 18: 246–59.CrossRefGoogle Scholar
Pierson, P. (1996), ‘The new politics of the welfare state’, World Politics, 48: 2, 143–79.CrossRefGoogle Scholar
Rabiee, P. and Glendinning, C. (2010), ‘Choice: what, when and why? Exploring the importance of choice to disabled people’, Disability and Society, 25: 7, 827–39.CrossRefGoogle Scholar
Reindal, S. M. (2010), ‘Independence, dependence, interdependence: some reflections on the subject and personal autonomy’, Disability and Society, 14: 3, 353–67.CrossRefGoogle Scholar
Rummery, K. (2009), ‘The role of cash-for-care in supporting disabled people's citizenship: gendered conflicts and dilemmas in social citizenship’, Social Policy and Administration, 43: 6, 634–48.CrossRefGoogle Scholar
Tonkens, E. (2011), ‘The embrace of responsibility: citizenship and governance of social care in the Netherlands’, in Newman, J. and Tonkens, E. (eds.), Participation, Responsibility and Choice: Summoning the Active Citizen in Western European Welfare States, Amsterdam: Amsterdam University Press, pp. 4566.Google Scholar
Tonkens, E. (1999), Het zelfontplooiiingsregime: De actualiteit van Dennendal en de jaren zestig, Amsterdam: Bert Bakker.Google Scholar
Tronto, J. (1993), Moral Boundaries: A Political Argument for an Ethic of Care, New York: Routledge.Google Scholar
Trydegård, G. B. and Thorslund, M. (2001), ‘Inequality in the welfare state? Local variation in care of the elderly – the case of Sweden’, International Journal of Social Welfare, 10: 174–84.CrossRefGoogle Scholar
Vabø, M. (2011), ‘Changing governance, changing needs interpretations: implications for universalism’, International Journal of Sociology and Social Policy, 31: 3/4, 197208.CrossRefGoogle Scholar
Verkerk, M. A. (2001), ‘The care perspective and autonomy’, Medicine, Health Care and Philosophy, 4: 3, 289–94.CrossRefGoogle ScholarPubMed
VWS (ministerie van Volksgezondheid, Welzijn en Sport) (1966), Kamerstuk Tweede Kamer 1965–1966 kamerstuknummer 8457 ondernummer 3, Algemene verzekering zware geneeskundige risico's Memorie van Toelichting, The Hague: VWS.Google Scholar
VWS (ministerie van Volksgezondheid, Welzijn en Sport) (1999), Zicht op zorg. Plan van aanpak modernisering AWB, The Hague: VWS.Google Scholar
VWS (ministerie van Volksgezondheid, Welzijn en Sport) (2008), Brief uitwerking pakketmaatregelen, 16 September 2008, www.rijksoverheid.nl/documenten-en-publicaties/kamerstukken/2008/09/16/uitwerking-awbz-pakketmaatregel.html [accessed 23 May 2011].Google Scholar
VWS (ministerie van Volksgezondheid, Welzijn en Sport) (2010), Pakketmaatregelen AWBZ hebben effect, Nieuwsbericht, 23 July 2010, www.rijksoverheid.nl/onderwerpen/algemene-wet-bijzondere-ziektekosten-awbz/nieuws/2010/07/23/pakketmaatregelen-awbz-hebben-effect.html [accessed 22 February 2011].Google Scholar
Waerness, K. (1984), ‘The rationality of caring’, Economic and Industrial Democracy, 5: 185211.CrossRefGoogle Scholar
Woittiez, I. and Sadiraj, K. (2010), Wie zijn de cliënten van de langdurige AWBZ-thuiszorg? The Hague: Sociaal en Cultureel Planbureau.Google Scholar