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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.
Gemeenten moeten in het kader van de Wmo de uitvoering van extramurale begeleiding van hun inwoners met beperkingen gaan verzorgen. Niemand weet hoe dit zal gaan lopen. Ellen Grootegoed en Martijn van Lanen ontwierpen een model met mogelijke scenario’s, om van te leren en als vertrekpunt voor debat.
In dit artikel gaan we na in hoeverre mantelzorgers met en zonder een vergoeding uit een persoonsbonden budget (pgb) van elkaar verschillen in kenmerken van de zorgsituatie, kenmerken van de mantelzorger zelf en de mate van belasting en ondersteuning. De gegevens zijn afkomstig uit het onderzoek Informele Hulp 2007 van het Centraal Bureau voor de Statistiek en het Sociaal en Cultureel Planbureau. De analyses hebben betrekking op 112 betaalde en 2336 onbetaalde mantelzorgers van 18 jaar en ouder. Mantelzorgers met een intensieve hulptaak krijgen relatief vaak een vergoeding via het pgb, net als verzorgers van personen met een verstandelijke beperking of personen die iemand verzorgen die veel emotionele steun nodig heeft; mantelzorgers van dementerenden zijn juist ondervertegenwoordigd in de analyses. Ook maken mantelzorgers die een verg...
This article examines how Dutch citizens with long-term care needs have used existing legal opportunities to respond to cuts in publicly financed care. Unexpectedly, most did not make use of their right to appeal the reduction or elimination of their previous entitlements, even when this led to marked problems in daily life. Thirty interviews with disabled and elderly persons and their care-givers revealed that specific social norms on how to feel about the cuts inhibited the lodging of appeals. Given the new policy's stated intention of preserving care for the most needy, many affected clients felt they had no right to be angry. Despite their (often objectively warranted) grievances, they did not appeal as breaking with the new moral code would trigger feelings of shame – of not being autonomous, of demanding too much when others are ...
Payments for care, by which people in need of long-term care directly employ care workers, have been introduced in many European countries. In The Netherlands, care dependants are allowed to use these payments to hire relatives to perform care tasks. Care-givers who are employed by their relatives are in a hybrid position, because they are contracted as employees in the informal setting of a family home and its affective care relationships. This paper reports a qualitative study of relatives' experiences of payments for care and how these affect their care-giving. In-depth interviews were undertaken with 17 paid carers: they were asked to respond to three fictional vignettes of contrasting care trajectories. It was found that the cash nexus had mixed and partly contradictory implications for the paid care-givers. On the one hand, the c...
Welfare state retrenchment and its corollary, the encouragement of ‘active citizenship’, are widespread phenomena in Western countries today. While public and academic debates have focused on the practical consequences of changing rules and shrinking entitlements, there has been much less attention on how citizens experience these reforms and their accompanying rhetoric. We know even less about how welfare reform impacts upon people's emotions. Such a focus, however, is important because the reform of the welfare state is about more than changing rights and duties. Reforms tell citizens what they are worth, how they are valued and judged, and how they are supposed to feel about the new arrangements.
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