Abstract
In countries with prevalent family care and less developed care services, it is important to understand the ways families cope with the care needs of their frail family members as part of policy learning to make care systems more sustainable. Filial care is a vital element of family care, yet is significantly restrained by the involvement of carers in the labour market; unequal gender distribution of the care burden; and insufficient recognition of, and policy support, for family care. This article considered the issue of the sustainability of elderly care in a familialist country, Slovenia, by identifying the coping strategies families adopt for the provision of care. To this end, in-depth qualitative data based on a purposeful sample of 55 community-resident users of social home care services and their 55 family carers were used. We identified five external coping strategies: use of formal care services, use of extended family network, use of wider community network, cohabitation, and home adjustments. Among internal strategies, we detected work-related adjustments; abandoning leisure activities; abandoning vacations; establishing new routines; accepting and finding satisfaction in care; increased psychological distress, such as worries and overburdening; and some unmet care recipient needs. Very few strategies may be described as supported by policy actions, despite such support being essential for increasing the sustainability of the family-based care model.
Highlights
Caregiving by spouses to partners or adult children to older parents is a crucial important care issue since the family remains the key provider of care for the elderly across Europe [1,2,3]
We distinguished in our analysis between coping strategies linked solely to the individual family carer/dyad and coping strategies that were embedded in the wider family and community, roughly following the internal–external strategies distinction already found in the literature
The sustainability of care in a familialist care regime is a relevant issue for family carers and policymakers
Summary
Caregiving by spouses to partners or adult children to older parents is a crucial important care issue since the family remains the key provider of care for the elderly across Europe [1,2,3]. Significant differences are visible among countries in the roles held by formal services and the family in providing care for the elderly. Similar variability is observed regarding the extent of public financing of long-term care services/systems among European countries. The costs of long-term care are highest in northern and western European countries and significantly lower elsewhere in Europe (ranging from 2.7% of GDP in Sweden to 0.2% in Hungary [4]). These differences are discussed in the literature according to different care regime typologies [1,5,6,7,8]. The most defamilialised countries are in northern Europe, while Mediterranean and central-eastern European countries are the most familialised
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