1 Successful ageing in long- term care: International comparison and lesson learning Dr Henglien Lisa Chen Lecturer in Social Work Scholl of Education and Social Work University of Sussex

Context Research aim and objectives Research method and methodology Key findings 2

3 Research aim and objectives To understand and evaluate current systems of care: To discover how long-term care of older people was provided in different countries and how their needs and interests were being identified and met To obtain a better understanding of the implications of long-term care for different welfare systems and to identify the factors that influenced the successful ageing of individuals being cared for England Netherlands Taiwan

Successful ageing in LTC: Key dimensions Autono my Social inclusion DLA 4 Success -ful ageing In LTC QoL QoC  Resources + Partnership

Elderly care regimes (Lamura et al. 2007; Esping-Andersen 1990, 1999) Lamura’s care regime Standard-care mixPublic-NordicFamily-based E-A’s welfare regime LiberalSocial democraticConservative Demand for caremedium to highmediumhigh Informal caremedium to lowlowmedium Formal caremediumhighlow Public and private care support to older people Minimum public care in kind followed by care in cash High public care in-kind followed by care in cash High self-funded. Low public care in cash (unconditional allowance) followed by care in kind Care market pluralism Low public and high for-profit sectors Low public and high non-profit sectors Mix of non-profit and for- profit sectors CountriesGermany, Austria, France, Italy, the UK. Sweden, Denmark, the Netherlands Spain, Portugal, Ireland, Greece, (Korea, China, Taiwan, Japan) 5

6 Design and Method Semi-structured interviews Informal carer (6 in England, 1 in the Netherlands and 3 in Taiwan) Formal care (5 in England, 9 in the Netherlands and 9 in Taiwan) Assessor (11 in England, 8 in the Netherlands and 11 in Taiwan) Service providers (10 in England, 7 in the Netherlands and 8 in Taiwan) Local administrators (4 in England, 4 in the Netherlands and 6 in Taiwan) Civil servants and national NGOs official (3 in England, 4 in the Netherlands and 6 in Taiwan ) Civil servants, national NGOs, senior officials Local administrators, service providers Assessors, formal carers, informal carers Service users

7 Key Findings Perspective at the macro, meso and micro levels

E.NN.LT.W. QoL DLAPersonal care to high dependent Personal designed Institutional Social inclusion Depend on self- reliance Various choiceHealth promotion AutonomyRights for complain Strong older people pressure group -Strong family influence - Consumerism QoC ResourcesPublically under funded Short of care workers Budget cut Highly professional Increasing state support Increasing professional PartnershipTop to down Carrot and stick ConsultationTop to down And Button up 8

References Chen, H.L. (under-review) ’The quantity and quality of care workers in long-term care for older people: challenges and responses’, International Journal of Social Welfare Chen, H.L. (in press) ‘Cross-national qualitative research into the long-term care of older people: some reflections on method and methodology’, European Journal of Social Work. Chen, H.L., (2010) ‘Cross-national inequalities: long-term care provision in the East and West’, International Journal of Sociology and Social Policy, vol. 30, no 3/4, pp Chen, H. L., (2009) ‘Successful ageing among older people needing care: International comparisons seeking solutions’, Journal of Social & Public Policy Review, vol. 3, no 1. pp Chen, H. L., (2007) ‘Power and autonomy of older people in long- term care: cross-national comparison and learning’, in Clarke, K. (ed.), Social Policy Review 19, Bristol: The Policy Press. pp

10 Successful ageing in long- term care: International comparison and lesson learning Dr Henglien Lisa Chen Lecturer in Social Work University of Sussex, England