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The other way around? New perspectives on LTC policies in old age care in Sweden and Spain

2016 Conference Presentation

Policy SpainSweden

6 September 2016

The other way around? New perspectives on LTC policies in old age care in Sweden and Spain

María Ángeles Tortosa, University of Valencia, Spain


Objective: The traditional perspective of analysing LTC polices often leads to a ‘catastrophic’ scenario of future old age care, and also the work-care balance for caregivers. This perspective put a lot of emphasis on purely demographic factors and employs a top-down approach. In medium-long term future most countries will need a huge amount of personal and financial resources for taking care of older people. This is a part of the ageing ‘future threats’. Therefore, there are good reasons to question this traditional perspective. The main aim of this study is to compare the traditional top-down perspective of analysis with a more bottom-up oriented perspective, which focus less on demographic factors, instead more on the role of family members (younger or older) and their work situations.

Data & methods: Sweden and Spain, which are both facing the challenges of an ageing society, were selected due to their different cultural, economic, family and labour market conditions, as they represent different points of departure: the Swedish welfare state model versus the Spanish family-based model. We use different macro and micro data for last decades from both countries about demographic, older care caregivers’ situation, family life and work conditions.

Results: Changing perspective of analysis from a top-down to bottom-up we pass from a ‘dramatic’ future scenario on old age care to a less pessimistic one with more clear options for action to help caregivers and older people in both countries.

Policy implications: A top-down oriented perspective leads to same type of problems in Sweden and Spain: enormous needs of persons and financial resources. That seems to imply same kind of solutions for both countries, policies more close reform paid care and in kind services, that is without considering the role of family transfers and older people as worker or caregivers.

Thinking the other way around, using bottom-up perspective provides new insights on families and older people needs and resources, and takes family as a central point for future developments of old age care policies. Sweden and Spain will have to apply both perspectives of analysis for better design of their LTC policies.