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1 – 10 of 630
Open Access
Article
Publication date: 20 July 2021

Martin Powell

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Abstract

Purpose

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Design/methodology/approach

It draws on Mossberger and Wolman’s (2003) framework which proposes criteria for assessing policy transfer as a form of prospective policy evaluation: awareness; assessment and application. The documents examined are the sources cited by the reports that examined funding LTC in England since 1999. The study uses interpretive content analysis in a deductive approach (applying the framework) that focuses on both manifest and latent content.

Findings

It finds that both the reports and the cited studies tend to focus on a fairly narrow range of nations, with most attention on Germany, Japan and Scotland. Most studies broadly do not provide much in the way of a clear rationale, and the level of details provided varies. There is relatively little focus on problems. Aims, objectives and goals are little mentioned in some studies, but they tend to be fairly abstract or “high level.” Similarly, there is limited detail on settings. Finally, only a few studies provide a clear recommendation.

Originality/value

It focuses on the neglected topic of the evidence behind reports which are intended to provide recommendations for policy change. The Mossberger and Wolman’s (2003) framework has been used in a small-scale but appears to be well-suited for this purpose.

Details

Fulbright Review of Economics and Policy, vol. 1 no. 1
Type: Research Article
ISSN: 2635-0173

Keywords

Open Access
Article
Publication date: 24 October 2022

Alex Hall, Gemma Spiers and Barbara Hanratty

A narrative has developed in recent years to link ageing without children to support needs in later life. Social care has long been viewed as a private, familial responsibility…

Abstract

Purpose

A narrative has developed in recent years to link ageing without children to support needs in later life. Social care has long been viewed as a private, familial responsibility, whilst health care is a societal, public good. Childlessness is framed negatively in terms of increased demands on care services and wider family networks. As governments tackle the issue of how to fund and deliver an equitable and sustainable long-term care sector, this paper aims to argue that it is more critical than ever to evaluate views of childlessness in the context of ageing.

Design/methodology/approach

Policy-oriented commentary paper.

Findings

If the focus on childlessness and ageing is through a lens of a potential care deficit, this continues to frame ageing without children as a risk and does little to challenge increasing reliance on unpaid care. Research and policy need to explore how to make access to social care more equitable and reduce expectations of unpaid care. They also need to increasingly emphasise exploration of aspects of later life beyond the issue of care, for example, by more of a focus on communities, what matters to people to age well and lives that extend beyond traditional views of nuclear families.

Originality/value

This paper uses the UK as a contextual example to argue that the research and policy communities have a role to play in evaluating their constructions of childlessness and ageing and questioning whether they do little more than legitimise government’s unwillingness to take responsibility for social care.

Details

Quality in Ageing and Older Adults, vol. 23 no. 4
Type: Research Article
ISSN: 1471-7794

Keywords

Open Access
Article
Publication date: 24 July 2019

Kanchana Tangchonlatip, Aphichat Chamratrithirong and Aksarapak Lucktong

Several studies revealed the importance of older persons’ contribution to society. The enhancement of their potential to engage in civic activities should be encouraged. The…

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Abstract

Purpose

Several studies revealed the importance of older persons’ contribution to society. The enhancement of their potential to engage in civic activities should be encouraged. The purpose of this paper is to investigate factors associated with their civic engagement potential.

Design/methodology/approach

Data are from Thailand’s National Survey of Older Persons conducted by the National Statistical Office in 2011. A sample of 24,433 persons aged 60 years or older was analyzed to assess their engagement in four community activities. The data were subjected to logistic regression analysis.

Findings

This study found that the readiness and willingness to engage in socially productive activities of Thai older persons ranged from 7 to 23 percent depending on type of activities. The factors of ageing health, confidence in their family’s ability to assist them, and satisfaction with government services were significantly associated with their readiness and willingness to engage in socially productive activities. Inadequacy of income was not found to be an obstructing factor toward their readiness and willingness to engage in civic life in general, it inhibited only the sharing of knowledge and skills with others.

Originality/value

The findings reflect the impact of internal constraining factors and external enhancing factors on engagement of Thai older persons in civic activities. Policy implications on the role of the government to promote active ageing are discussed.

Details

Journal of Health Research, vol. 33 no. 5
Type: Research Article
ISSN: 2586-940X

Keywords

Open Access
Article
Publication date: 23 July 2018

Phudit Tejativaddhana, David Briggs, Orapin Singhadej and Reggie Hinoguin

The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to…

10216

Abstract

Purpose

The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management.

Design/methodology/approach

The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure.

Findings

The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality.

Originality/value

The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

Details

Public Administration and Policy, vol. 21 no. 1
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 25 May 2023

Amanda Phelan

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in…

1525

Abstract

Purpose

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in policy, regulation, practice and legislation.

Design/methodology/approach

A review of historical and current contexts in adult safeguarding in Ireland is presented with consideration of key public reviews and commentaries related to care provision, governance and the legislative status of adults at risk.

Findings

While Ireland’s journey to provide adult safeguarding responses for older people has progressed since 2002, there remain many gaps. Further work needs to be addressed urgently to enable a comprehensive alignment of fit-for-purpose, responsive legislation, practice and policy to meet the complex and diverse needs of an increasing ageing population who may require safeguarding support. This includes fostering robust inter-sectorial collaboration, safeguarding legislation and cultural change related to human rights approaches.

Research limitations/implications

The paper is a discussion on the context of adults safeguarding in relation to practice, policy and legislation.

Practical implications

Identifies the need for significant reform in the Irish system of health service. Argues for an overarching, inter-sectorial approach to addressing adult safeguarding, which focuses on prevention as well as early intervention.

Originality/value

The paper offers a review of the current diverse elements comprising current adult safeguarding and older people in Ireland and integrates legislative, regulatory, policy and practice realities. Challenges are illustrated within the context of reactive rather than proactive safeguarding agendas which are linked to public scandals and debates. The paper argues for a more integrated and robust inter-sectorial approach to safeguarding underpinned by adult safeguarding legislation and an overarching governance structure.

Details

The Journal of Adult Protection, vol. 25 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

Open Access
Article
Publication date: 30 March 2022

Phudit Tejativaddhana, Nalinee Nakittipha Chuakhamfoo and Man Thi Hue Vo

This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and…

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Abstract

Purpose

This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and the implications for The Association of Southeast Asian Nations (ASEAN) countries.

Design/methodology/approach

Online databases from international, national, academic agencies and SCOPUS database from January 2019 to July 2021 were utilized for analysis. Relevant literature and data were selected for review.

Findings

The evidence suggests that the proportion of the aging population is increasing due to declined fertility and rising life expectancy. Current and future demand for effective healthcare in ASEAN will be better achieved with policies like the Universal Health Coverage and Primary Health Care system. While some countries, specifically Thailand, are developing and expanding their LTC policies, some concerns regarding the active aging policy remain. Most ASEAN countries are using public domain for LTC policies. However, the COVID-19 pandemic has posed a major challenge in implementing LTC and affected the vulnerable aging population in many aspects, including social protection issues in Thailand.

Originality/value

With the support from international organizations, ASEAN countries have framed several policy strategies in response to the increasing aging population, such as providing more LTC in the community. The unexpected challenges from the COVID-19 pandemic compel policymakers to consider resource allocations and community-based services. On the positive side, as the pandemic has made the vulnerable group exposed, social protection issues have been brought to the forefront of the political debate and called for an appropriate policy response.

Details

Public Administration and Policy, vol. 25 no. 1
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 3 April 2019

Wilson Amorim, AndréLuiz Fischer and Fabiana Bitencourt Fevorini

This paper deals with the insertion of workers aged 50 years or more in the Brazilian labor market. Considering this question, the purpose of this paper is to raise evidence about…

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Abstract

Purpose

This paper deals with the insertion of workers aged 50 years or more in the Brazilian labor market. Considering this question, the purpose of this paper is to raise evidence about the existence of ageism – prejudice against that age range. The paper identifies the characteristics of participation by workers age 50 or older in Brazil’s formal labor market. The paper also identifies whether and how the specific issues of these workers are handled in the individual employment contract, with the human resources management (HRM) policies and practices of a group of companies.

Design/methodology/approach

The study applied a quantitative approach in an analysis of the older population in the Brazilian labor market (Annual Social Information Report (RAIS) database and “MEPT” survey database – 2011/2016). The RAIS data are collected annually by the Ministério do Trabalho e Emprego – MTE, coming from all establishments with or without formal employees, whether statutory (public servants) or private organizations. MEPT survey is an annual study focused on quality of the organizational environment and HRM practices (organizations participate voluntarily). A qualitative approach was applied also in a document content analysis on information about HRM policies and practices based on MEPT companies’ research evidence reports.

Findings

There is evidence of ageism among private companies in Brazil with better HRM. These companies hire proportionally less old workers than the market and their HRM policies and practices scarcely handle with employees. The workers age 50 and over among the workers employed (private and mixed capital companies) have growing participation in the labor market. The profile of these workers is predominantly male, higher level education considering the market average, and working under longer lasting formal contracts comparing all workers combined. People involved in the individual hiring of workers from this age group do not even give this subject much attention.

Research limitations/implications

The specific objective of verifying if and how the specific issues that workers of 50 years and older are dealing; in the individual hiring for work, encountered limitations based on the restricted character of the data presented. In particular, the information related to the best companies (MEPT) is representative only of its own group and thus is restricted to the private sector. Although this cannot be generalized, they offer support for reflections on the subject.

Practical implications

This paper shows how companies with advanced HRM handle with older workers in their policies and practices.

Social implications

This work points out that that the aging of workers will be a problem to be discussed by the companies HRM in the future.

Originality/value

This paper identifies the need to study how companies will deal with the increasing number of older workers.

Details

Revista de Gestão, vol. 26 no. 2
Type: Research Article
ISSN: 2177-8736

Keywords

Open Access
Article
Publication date: 22 November 2018

Toni Wright and Stephen O’Connor

The purpose of this paper is to scope out European and global policy documents focused on dementia with the purpose of providing a synthesis of the challenges the phenomenon poses…

3251

Abstract

Purpose

The purpose of this paper is to scope out European and global policy documents focused on dementia with the purpose of providing a synthesis of the challenges the phenomenon poses and the gaps evident.

Design/methodology/approach

An adapted PESTEL framework as a data extraction tool resulted in an analysis of the political, economic, social, technological, environmental, organisational, educational and research aspects of dementia policy.

Findings

Policy documents showed variability of dementia strategy, plan and programme development. All documents recognised rapidly growing ageing populations, and increasing numbers of people living with dementia. Dementia as a public health priority is inconsistent in growth. Global policy documents stress the impact of dementia will be felt most by low- and middle-income countries. Main themes were: a need to raise awareness of dementia and action to reduce stigma around it, the need for early diagnosis and preventative person-centred approaches with integrated care, fiscal investment, further research, training and education for workforces, increased involvement of and support for people living with dementia and care and support close to home.

Practical implications

By identifying current dementia challenges and policy gap implications this analysis urges engagement with broader frames of reference as potential for enabling bolder and radically better dementia care models.

Originality/value

This paper offers a review of present global and European dementia policy, outlining the potential implications for the most marginalised in society if it fails to be critical of its own underpinning assumptions.

Details

Journal of Public Mental Health, vol. 17 no. 4
Type: Research Article
ISSN: 1746-5729

Keywords

Open Access
Article
Publication date: 29 April 2021

C.V. Irshad and Umakant Dash

Recent public health policy emphasizes the achievement of healthy aging as average life expectancy increases worldwide. Evidence for healthy aging from low- and middle-income…

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Abstract

Purpose

Recent public health policy emphasizes the achievement of healthy aging as average life expectancy increases worldwide. Evidence for healthy aging from low- and middle-income countries (LMIC) is limited. The purpose of this paper is to assess the prospects of healthy aging and its associated factors in the Indian context.

Design/methodology/approach

The study was based on a national-level panel survey, the Indian Human Development Survey (IHDS) conducted in 2004-05 and 2011-12. The analytical sample consists of 10,218 elderly individuals who were 60 years old and above at the baseline. Change in health status was assessed based on disability and disease incidence at the follow-up. A generalized estimating equation (GEE) model was performed to assess health status change.

Findings

Increasing age was a risk factor for all dimensions of health outcomes. Elderly from the lowest wealth quintiles were more likely to lose health due to short-term morbidity, whereas the highest wealth quintiles were more likely to lose health due to long-term and multi-morbidity, indicating evidence for the presence of the “disease of affluence”. Social capital, such as living in a joint family acted as a protective factor against health risks.

Originality/value

With the results showing the evidence of the “disease of affluence” and “disease of poverty” in different health outcomes, there should be a health policy focus that copes with undergoing epidemiological transition. It is also important to pay attention to health-protecting factors such as social and familial support to achieve healthy aging.

Details

Journal of Health Research, vol. 36 no. 4
Type: Research Article
ISSN: 0857-4421

Keywords

Open Access
Article
Publication date: 10 August 2020

David Bogataj, Valerija Rogelj, Marija Bogataj and Eneja Drobež

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent…

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Abstract

Purpose

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.

Design/methodology/approach

The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.

Findings

The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.

Research limitations/implications

The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.

Practical implications

The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.

Social implications

The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.

Originality/value

While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

Details

Facilities, vol. 38 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

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