The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain

Abstract

Background: Older individuals with long-term care (LTC) needs represent a risk factor for poverty and socioeconomic deprivation (SED) for households. This challenge threatens the overall sustainability of health and social care systems. Spain and Italy have a robust family-based care regime with a high level of informal long-term care. Aims: This qualitative study aims to provide empirical evidence of the socioeconomic risks for Spanish and Italian households related to long-term care needs by identifying the phenomenon’s main characteristics and suggestions for innovative policies and solutions. In particular, this qualitative study examines the opinions of experts and stakeholders from both countries to: (a) explore the relationship between LTC needs and household SED risk in Spain and Italy; (b) identify key associations between words and concepts, highlighting their specific characteristics in both countries; and (c) perform an in-depth analysis of the interviewees’ views on designing innovative policies to support households, aimed at coping with the SED risk arising from the challenges posed by meeting the LTC needs of older people and their relatives Methods: National experts and stakeholders were involved in interviews and focus groups in both countries. A linguistic and content analysis of the transcriptions produced was performed and supported by T-LAB. Results: The SED risk for households was confirmed in both countries. Informal carers, often women, contend with a higher risk of material and social deprivation. To improve the coordination and integration strategy of public LTC, policies should contrast the SED risk of households. Moreover, an innovative integrated welfare model should consider valorizing different existing resources (e.g., informal care, neighbors, and NGOs). Conclusions: Long-term care policies aimed at promoting ageing need to pay more attention to such a risk as a structural component to be addressed and tackled with more specific and effective strategies.