Social Care For Older People

A lot of later life care is centred on the family. A member of a family, usually an adult daughter or son, informally care for an older parent. Families often include people who are biological kin but who hold a similar status – ‘fictive kin’. For example, a long-term neighbour or friend from school might be known as an Aunty or Uncle. Often the biological child or ‘fictive kin’ is the ‘go-between’ between older parent(s) and formal care services. They perform an essential role in maintaining the dignity and independence of the older person(s) and facilitate access into and out of care services. However, over the last few decades there has been a change in the shape of families. This change is linked to long-term decline in fertility rate, the rise in the age of mortality, economics, increase in divorce rate and stepfamilies. Not only are families smaller than they once were but there is an increase in number of people ageing without children.

Les transformations politiques, familiales, religieuses, économiques et spatiales amènent à rompre avec les évidences entretenues sur les sociétés africaines comme celles de care au profit des personnes âgées au nom du respect social des âges. Ce travail déconstruit les représentations sociales de la vieillesse en montrant d’une part que les catégories de la vieillesse sont les produits des politiques publiques et d’autre part que les vieillesses sont hétérogènes, contextuelles et dynamiques. A partir d’études de cas élargis, cette thèse explore les expériences du vieillir à partir des formes de prise en charge des personnes vieillissantes dans la capitale Ouagadougou (Burkina Faso).Une ethnographie au sein des familles, dans une unité de soins spécialisé dans un centre hospitalier universitaire et dans un centre d’accueil de femmes accusées de sorcellerie permet de décrypter les relations complexes de prise en charge entre le niveau micro et macro sociale. Cette thèse est une contribution à une anthropologie du care de la vieillesse. 

Mots clés: personnes vieillissantes, care, familles, hôpital, centre d’hébergement, femmes accusées de sorcellerie

It means that as a senior carer I am accountable and responsible for the care of the individuals within my working environment. The manager understands that I am to protect vulnerable persons from abuse/neglect and actively report any malicious intent, the person causing damage must refrain from doing so immediately, and a report filed if necessary with the appropriate authorities. I must record data accurately to ensure continuity of care between professionals and accepted personnel within Heath Cottage at all times. I must co-operate and contact any outside agencies as requested/required to care for the health of the vulnerable person within my care. I am completely responsible for any ill-health/harm or injury.

Education permanente, Tome 196, n°3, p. 175-184.

Cet article interroge l’activité de soins aux personnes âgées dépendantes et le rôle joué par le collectif de travail dans le développement et les transformations de cette activité. Source d’obligations, le collectif y joue un rôle équivoque, limitant les initiatives en terme de soins, et réglant de manière stricte l’usage du temps, devenu un enjeu majeur de l’activité. Il s’agit donc de comprendre comment les soignants parviennent, dans un contexte où leurs marges de manœuvres sont réduites, à opérer des recréations de l’activité afin de réaliser des soins à la personne âgée. Nous montrons qu’en dehors des ressources pourvues par le collectif de travail peuvent être mobilisées d’autres ressources, issues de l’histoire personnelle, des relations interpersonnelles, notamment familiales, et de formations trans-individuelles.

This article questions the care activity of older dependent people and interrogates the part played by the work collective in the development of this activity. The work collective’s part is equivocal and produces some obligations who limit the care initiatives. It sorts the use of time who became a major activity issue. We try to understand how the care givers reach to recreate, in a constraining context, the activity in order to carry out some treatment to elderly person. We show that others resources exist, apart from the collective’s resources. These resources come from the personal history, interpersonal or family relationships and transindividual trainings.

Na esteira da alteração dos padrões demográficos, a velhice marca de modo sem precedentes a sociedade contemporânea. Ser idoso tem sido largamente descrito na literatura como uma experiência de solidão, sentimento de caráter multifacetado que se origina na insatisfação com as relações interpessoais. Este trabalho foca a associação entre tal estado psíquico e o envelhecimento, e mensura a incidência deste sentimento em uma amostra composta por 64 idosos que participaram do projeto Bem Envelhecer, da Rede Europeia Anti-Pobreza (EAPN/Portugal). Privilegia-se neste estudo a relação entre as variadas dimensões da solidão e o cruzamento da mesma com diversas variáveis. Para tanto, fora aplicado um inquérito com questões sociodemográficas e a escala SELSA-S (Short Version of the Social and Emotional Loneliness Scale for Adults). Os resultados apontam para a preponderância entre os participantes da pesquisa dos vínculos familiares, em detrimento dos sociais e românticos, e o período etário ...

This article provides information on the care provided by caregivers to seniors with a long-term health condition, a disability or problems related to aging. It focuses on how the intensity and nature of the care vary depending on seniors’ type of housing. Four types of housing are examined: care facilities, supportive housing, private households separate from the caregiver, and private households shared with the caregiver.

Care is a social necessity for life. Ensuring access to appropriate care at crucial points in the life course became a political necessity soon after the mid-20th century, as the right to suitable care became recognized as a fundamental entitlement of citizenship in most advanced capitalist economies. Over recent decades there has been a shift away from more traditional welfare state forms of public services towards increasingly marketized systems of provision. Changes in the provision of care in the public domain are associated with an increasing reliance on private capital and competition between a variety of providers, with public agencies competing alongside private for-profit and not-for-profit agencies. Drawing on care theory, historical sociology and political economic analysis, this article examines the conflicting tensions that shape aged care under marketization. Using Australia as a case study, it is argued that as private capital and resources take the place of scarce public resources and enable expenditure cuts to be presented as innovation, better services and more 'consumer choice', it is not the market but the finance, regulation and management work of the state that is the essential determinant of the assistance previously provided through non-market processes.

The purpose of this brief note is to present a discussion of the first two sessions of a poetry group conducted with moderately to severely cognitively impaired adults in a nursing home. Exercises and techniques used with this population are discussed. Poetry groups such as this may provide joy those who suffer, a chance to re-experience memories, to connect to others, and the creation of moments of increased value and meaning.

Dans les EMS psychogériatriques qui se sont tournés vers la « Méthode Montessori adaptée », plusieurs formes du « prendre soin » coexistent. Les équipes professionnelles les mieux armées ne sont-elles pas celles qui parviennent à les composer ? Par Fabienne Malbois, chargée de recherche, Anne Jetzer, maître d'enseignement, et Alexandre Lambelet, professeur associé, Réseau de compétence « Age, vieillissement et fin de vie », Haute école de travail social et de la santé Lausanne (HES-SO) En Suisse, près de la moitié des personnes âgées atteintes de démence vivent en EMS. En raison des troubles qui les affectent (apraxie, aphasie, agnosie), auxquels peut s'ajouter de l'agressivité aux stades les plus sévères de la maladie, ces publics nécessitent un accompagnement psychogériatrique spécifique. La culture organisationnelle et professionnelle des EMS, héritée de l'hôpital, est peu adaptée à sa mise en oeuvre et difficile à réformer (Lambelet, Pichonnaz & Hugentobler, 2017). Nombre d'établissements se tournent vers des modèles alternatifs d'intervention en gérontologie, centrés sur un accompagnement personnalisé de la personne âgée. Parmi eux, la « Méthode Montessori adaptée » (AG&D, 2019), MMA ci-après, connaît un vif succès. Entre 2018 et 2019, les auteurs [1] de l'article ont réalisé une enquête ethnographique dans cinq EMS vaudois qui ont formé leurs personnels à cette méthode, dans la perspective de cerner la transformation des pratiques professionnelles induite par cette nouvelle orientation [2]. La « Méthode Montessori adaptée » Façonnée aux États-Unis par un neuropsychologue (Camp, 2010), la MMA s'inspire des principes pédagogiques développés par Maria Montessori et vise à faire émerger, dans les institutions, une vision interprofessionnelle commune. L'ensemble des praticiens sont concernés, que leurs interventions se déploient, selon les tâches traditionnellement dévolues aux différents secteurs, dans la relation directe avec les personnes âgées (les soins, l'animation, le service socio-hôtelier), ou indirectement (le service technique, l'administration, l'intendance). Comment citer cet article ? Fabienne Malbois, Anne Jetzer et Alexandre Lambelet, «Les formes variées du "prendre soin" en EMS», REISO, Revue d'information sociale, mis en ligne le 16 mars 2020, https://www.reiso.org/document/5725 Les formes variées du «prendre soin» en EMS

The moral argument for supporting carers is clear and irrefutable. This report takes the argument beyond morality and demonstrates that supporting carers improves health outcomes for patients and carers; reduces unwanted admissions, readmissions and delayed discharges in hospital settings; and reduces unwanted residential care admissions and length of stays.

Nas últimas décadas, tem-se assistido a uma crescente preocupação pelo desenvolvimento socialmente justo e sustentável; daí que as políticas de desenvolvimento que se têm delineado têm implícita uma preocupação de maior equidade e justiça, aprendendo do passado para assim projetar o futuro. Ora quem aprecia o horizonte, sem menosprezar o seu espólio e memória, vive o momento presente empenhado em viabilizar o porvir. Esta atitude implica uma postura comprometida dos cidadãos com o social. E desta forma comprometida, empreendedora e corresponsável que se compreende o capital social como meio de desenvolvimento sustentável. Com este estudo procura-se perceber até que ponto o capital social é um dos fatores determinantes do desenvolvimento sustentável. Indagam-se, para isso, os indicadores que melhor podem medir o capital social. De uma forma mais específica, procura-se compreender até que ponto a sociedade portuguesa tem estimulado o capital social como recurso fundamental para o seu desenvolvimento. Esta questão é ilustrada a partir do inquérito do European Values Survey e, de uma forma longitudinal, analisam-se os comportamentos dos portugueses entre 1990 e 2008. Os resultados mostram que os portugueses não estão ainda sensibilizados para a problemática do desenvolvimento sustentável, revelam posturas muito fechadas, pouco ou nada preocupadas com a construção de uma sociedade mais ativa e comprometida com o bem comum.

Purpose-The purpose of this paper is to explore the impact of personalisation policy on the providers of social care services in England, mainly to older people, within the context of austerity and different conceptions of personalisation. Design/methodology/approach-The paper draws on part of a longitudinal study of the care workforce, which involved 188 interviews with managers and staff, undertaken in two rounds. Findings-Four themes were identified: changing understandings and awareness of personalisation; adapting services to fit new requirements; differences in contracting; and the impact on business viability. Research limitations/implications-The paper reflects a second look at the data focussing on a particular theme, which was not the focus of the research study. Furthermore, the data were gathered from self-selecting participants working in services in four contrasting areas, rather than a representative sample. Practical implications-The research raises questions about the impact of a commercial model of "personalised care", involving personal budgets (PBs) and spot contracts, on the stability of social care markets. Without a pluralistic, well-funded and vibrant social care market, it is hard to increase the consumer choice of services from a range of possible providers and, therefore, fulfil the government's purposes for personalisation, particularly in a context of falling revenues from local authorities. Originality/value-The research presents an analysis of interviews with care providers and care workers mainly working with older people. Their views on personalisation have not often been considered in contrast to the sizeable literature on PBs recipients and social workers.

Focussing on broad, international developments in the provision of aged care, this article explores the outcomes of the interaction of social and economic pressures on the way that care is conceptualised and provided. As it has gone from a private, familial duty structured by gender to a public responsibility, three key social-economic factors are identified as increasingly important in setting constraints on the options for its further development: the characteristics of care as a form of personal service; the cost issues associated with financing social policies for an ageing population; economic developments on a global scale used to justify increasingly sharp divisions between professional managerial staff and the larger care workforce which is increasingly insecure and treated as disposable.

This article describes how residents and staff of an eldercare and Alzheimer's home in a small South African town joke with each other. Residents are mostly white and staff mostly black, but there are exceptions, and both groups are multilingual. Jokes between the two groups in the home are racialized, if not sometimes racist, in light of historical and contemporary post-apartheid socio-political and economic circumstances. Yet the relations between these two groups are forged mostly in joking about residents’ diminished cognitive and bodily abilities, staff work, multilingualism and interpersonal ties. In describing joking encounters in three ethnographic scenes, the article traces the ways in which age and race combine in institutionalized relationships of dependency to innovate social theory about human mutuality from the vantage point of multiracial, multicultural, postcolonial Africa.

Contemporary research into health treats diagnosis as a central step in illness management and trajectories. Most public health policies, especially in the case of Alzheimer’s disease, claim that the earlier a diagnosis is made, the better it is for patients and caregivers. Quantitative and qualitative analysis from our longitudinal interview study, conducted with 60 caregivers of persons diagnosed with dementia, shows that this usual model of diagnosis [symptoms → diagnosis → meaning and caregiving] should be nuanced. First, diagnosis does not follow increased symptoms, but occurs rather through a process involving the observability of patients’ troubles and their interpretation of said troubles as requiring medical assistance ‐the ‘trouble?observability?interpretation convergence.’ Second, diagnosis does not systematically trigger the mobilisation of a caregiving network: such mobilisation may follow the diagnosis, but it can also provoke it, temporarily prevent it, or have no immediate impact. These observations beg the question: To what extent does diagnosis matter? We conclude by questioning the centrality of diagnosis in the illness trajectories and its crucial role in the mobilisation of a caregiving network, that is often taken for granted, and propose to distinguish between ‘anticipation diagnosis’ and ‘emergency diagnosis’.

Aim

As the population ages, the problem of dementia increases and affects a growing number of people. People with mental illness are known to be stigmatised and this has been the subject of numerous studies. There have been contradictory studies assessing the stigma attached to dementia, and the majority focus on stigma at a social level and the public perception of people with dementia. There have been a number of projects that included a study group of people with dementia. However, to date, this topic has not been discussed in Poland. Hence, the aim of this paper is to carry out a literature review addressing this issue.

Perspective

The problem of stigma attached to dementia is particularly significant as it affects not only the subject, but also their family, friends and health professionals. As people with dementia develop cognitive impairment and lose their independence, stigmatisation leads to their social isolation, despite their need for care. Stigma has emotional, behavioural and social implications, including diminished self-esteem, a feeling of anxiety and the development of a sense of shame and a fear of the judgement of others. Family members also deal with the stigma, which manifests itself as embarrassment and anxiety and causes their circle of friends and acquaintances to decrease. Current studies show that professionals can also play a negative role in the process of labelling and stigmatisation of patients.

Conclusion

Stigma is a serious and common problem in dementia. It seems necessary to target this issue in research and social discourse.

Na esteira da alteração dos padrões demográficos, a velhice marca de modo sem precedentes a sociedade contemporânea. Ser idoso tem sido largamente descrito na literatura como uma experiência de solidão, sentimento de caráter multifacetado que se origina na insatisfação com as relações interpessoais. Este trabalho foca a associação entre tal estado psíquico e o envelhecimento, e mensura a incidência deste sentimento em uma amostra composta por 64 idosos que participaram do projeto Bem Envelhecer, da Rede Europeia Anti-Pobreza (EAPN/Portugal). Privilegia-se neste estudo a relação entre as variadas dimensões da solidão e o cruzamento da mesma com diversas variáveis. Para tanto, fora aplicado um inquérito com questões sociodemográficas e a escala SELSA-S (Short Version of the Social and Emotional Loneliness Scale for Adults). Os resultados apontam para a preponderância entre os participantes da pesquisa dos vínculos familiares, em detrimento dos sociais e românticos, e o período etário de 60 a 70 anos como particularmente vulnerável à emergência da solidão. 

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In the wake of changes to demographic patterns, old age marks, in a manner without precedent, contemporary society. Being an older person has been broadly described in the literature as a solitary experience, a feeling with a multifaceted character that is determined by insatisfaction with interpersonal relationships. This study seeks to evaluate the scale of the different dimensions of this phenomenon (familial, social, romantic) in the group of older persons who participated in the project Successful Aging of the European Antipoverty Network - Portugal. We further seek to study the association between the socio-demographic characteristics of the target-population and the diverse dimensions of loneliness. To this end, a questionnaire containing socio-demographic questions and the SELSA-S scale (Short Version of the Social and Emotional Loneliness Scale for Adults) was applied on a group of 64 older persons. The results indicate a greater vulnerability of the 'younger' older persons to loneliness and the preponderance of the familial dimension of loneliness when compared with the social and romantic dimensions of this phenomenon.

Social care policies from the UK and Spain are analysed in this paper. They have been selected with a view to showing illustrative cases concerning the contract culture between sectors who were involved in the mixed economy of welfare (MEW) in the early 1990s. The paper explores the implications of this transition and how it transformed the rationale of the private and voluntary sectors delivering public services. The failure of the state was characterised by its limited organisational structure and a growing expansion of demand for welfare services. In this sense, new actors appeared eventually, motivated on the one hand by their desire to fulfil the state’s responsibilities in social provisions and on the other by the state aiming to release some pressures on its budget.

Keywords
Welfare state, welfare mix, public policy, economy, social care, United Kingdom, Spain

D’un espace dyadique soignant-soigné, la relation de soin a évolué au cours des dernières décennies vers une triangulation intégrant de plus en plus, dans le processus décisionnel et organisationnel des soins, l’aidant proche. De même, le cadre relationnel du soin entre les acteurs a progressivement basculé de l’hôpital vers le domicile.
Deux facteurs sociaux expliquent cette transformation: le désir sociétal de vouloir rester le plus longtemps chez soi lors du vieillissement et la prévalence d’une chronicisation des maladies nécessitant un suivi au quotidien sans besoin réel d’hospitalisation. Dès lors, les fonctions relationnelles du soin ont été amenées à évoluer d’une logique de cure (donner soin) vers une logique de care (prendre soin).
C’est à partir de ce triple constat que ce chapitre aborde la question de la confiance dans la relation en contexte de soins à domicile et de maladie chronique pour et auprès d’un sujet âgé en analysant plus particulièrement les variations sémantiques du donner et prendre soin dans la mobilisation des pratiques info-communicationnelles.
La mobilisation des éléments issus de la caractérisation des fonctions de la relation du « prendre soin » fournit un cadre d’analyse exploratoire aux possibilités d’une possible médiatisation du care.

Purpose: In 2030, the United States will face a caregiver deficit. Currently, family members are taking on the role of unpaid caregiver as a key component to the American Healthcare system. Many family members take on this role out of love and familial obligation. As families assume this daunting task, they also take on a level of intense caregiver burden that causes stress on the caregiver in multiple aspects of their life. The purpose of this research is to explore and describe how caregivers use social media forums to address the financial, physical, mental, and relationship stresses of caregiving. By examining social media forums, this research describes the issues of the current caregiving environment. As the need for more caregivers’ increases with the retirement and health decline of the Baby Boomer generation, the public policy implications increase as well. The American Healthcare System, public policy, and senior care public programs are behooved to reform as caregiver burdens and resources become limited.
Methodology: The literature identified the categories of caregiver burden: relationship burden, financial burden, and health concerns. These three categories were used to explore social media forum Aging.com Caregiver Forum. The forum is used by caregivers where they connect, seek advice, and relate about their caregiving experiences. The framework developed from the literature divides caregiver questions and responses into the three categories included in this research. The subcategories included under the relationship burden, financial burden, and health concerns are displayed in the results data, where the question, answers, and number of likes and comments were analyzed.
Findings: Caregivers used Aging.com Caregiver Forum to ask each questions and gather recommendations. Many caregivers utilized this social media outlet as a support group. The topics and subcategories were divided to show where caregivers are experiencing the most burdens. Financial and Relationship burdens were clearly identified in this research. This explains the challenges caregivers face with the family dynamics, as well as the financial constraints and stress in the caregiving experience. As the Baby Boomer Generation increases in age and declines in health, public policy and programs will need to adapt to this growing scarcity of unpaid informal family caregivers.

بما أن الناس يعيشون الآن إلى عمر أكبر، فمن المحتم أن تصبح قضايا الأمراض العقلية التنكسية أكثر أهمية. حيث يعد الأشخاص الذين يعانون من  اً ا قطاع ً أمراض الخرف وأهمها الزهايمر حالي منسيا في المجتمع، . ا نقص في الوعي والفهم وإن الخوف والجهل فيها يثير ً وبالتالي هناك عموم الشعور بالعار والتعامل بطريقة نمطية معها من قبل المجتمعات المحيطة.
نحن بحاجة إلى مواجهة جهلنا النسبي بهذه الأمراض والعمل على تشخيصها ورعايتها وعلاجها. وحاولنا ذلك من خلال مشروع لتصميم قرية نموذجية لمرضى الزهايمر تم تطويره بالمشاركة مع مجموعة من الأشخاص المتضررين من الزهايمر لمواجهة تحديات الحياة الحقيقية.
حيث يحاول المشروع على وجه التحديد التصميم للأشخاص المصابين بالزهايمر في محاولة لطمس الحدود بين الواقع الصحي المؤسسي والحياة الواقعية من خلال التأكيد على الحواس المدركة وغير المدركة. 
فمن خلال التجارب الجماعية، يعيش المقيمون  في حين قد يختبر أعضاء ، ا بالحياة الطبيعية ً شعور فريق العمل ويفسرون الخلط بين الواقع في عيون وعقول من يهتمون بهم. تهدف الرعاية السكنية إلى العمل مع احتياجات الفرد، وتقديم الدعم في مراحل مختلفة من الدعم الفردي إلى الدعم المجتمعي الكامل، مما يعزز فكرة البيئات المجاورة المألوفة. تتضمن الوحدات السكنية والمباني العامة والخدمية المبادئ التوجيهية الحالية في التصميم لمرضى الزهايمر، مما يعكس البحوث الموسعة في أفضل الممارسات. 
في هذه القرية، لن تكون هناك معاطف بيضاء، يوجد مطعم، مكتبة، سينما، حديقة، نادي رياضي، يمكن التسوق من مركز تجاري صغير، والذهاب إلى مصففي الشعر، حيث يتم تطبيق منهجا طبيا غير تقليدي، سيضمن بيئة إيجابية داخل الوحدات السكنية.
إن أحد أهم السياسات المتبعة في إطار الرعاية الصحية الحديثة هي استمرارية حياة المقيم وذلك بتأمين بيئة معيشية قريبة قدر الإمكان مما يتذكره الانسان من الماضي مما يمنحه الثقة والشعور بالأمان وقد أثبتت فعاليتها من خلال تحسن مؤقت في الأعراض. والمساعدة على زيادة الوظائف  .ً

The task of studying the impact of social class on physical and mental health involves, among other things, the use of a conceptual toolbox that defines what social class is, establishes how to measure it, and sets criteria that help distinguish it from closely related concepts. One field that has recently witnessed a wealth of theoretical and conceptual research on social class is psychology, but geographers' and sociologists' attitude of diffidence toward this " positivistic " discipline has prevented them from taking advantage of this body of scholarship. This paper aims to highlight some of the most important developments in the psychological study of social class and social mobility that speak to the long-standing concerns of health geographers and sociologists with how social position, perceptions, social comparisons, and class-based identities impact health and well-being.
DOI: https://doi.org/10.1016/j.socscimed.2017.11.037

Современная Россия входит в ряд стран, в которых активно происходят процессы старения населения. Проблема организации ухода за пожилыми становится все более заметной. Особенно это касается группы пожилых старше 75 лет, испытывающих проблемы с мобильностью и нуждающихся в сторонней помощи. Еще более остро она встает в российских поселениях, отдаленных от крупных урбанизированных центров. Почему происходит так, кто и как пытается решать эту проблему — изучению этих вопросов посвящена данная статья.

En este artículo hacemos una reflexión teórica sobre los principios morales que coexisten en las responsabilidades de cuidado. El don, la reciprocidad y la mercancía conforman sistemas morales diferenciados que a menudo operan en direcciones contrapuestas. No hay una sola ética del cuidado, sino diversas. Obligación y deuda están intrínsecamente relacionadas. Estar en deuda es la base del sistema moral que articula las responsabilidades de cuidados. Pero esta obligación moral está desigualmente repartida entre hombres y mujeres, así como entre la familia y el conjunto social. Un sentido de justicia social demanda un sentido más amplio de obligación. Es en el marco de la deuda social donde podemos avanzar hacia un reparto equilibrado del cuidado entre sexos y generaciones y una responsabilidad compartida entre individuo, familia, Estado y comunidad.

Helyzetkép és problémák GYARMATI ANDREA 2019 április A gondozási szükséglet folyamatosan nő Magyarországon. A 65 év feletti korosztály létszáma 1, 8 millió fő, közülük 1,3 millió fő él valamilyen korlátozottsággal. Otthonközeli ellátás (házi segítségnyújtás) azonban a korcsoportnak csupán a 7%-a számára elér-hető. Szakellátást az idősek otthonában az idősek 3%-a tudja igénybe venni, miközben a várakozók száma folyamatos növekedés mellett már jelenleg is meghaladja az ellátást igénybe vevők felét. Az utóbbi 8 évben központi állami fenntartásban működő idősek otthonában új férőhely nem jött létre. Az alapszolgáltatások biztosítása (étkeztetés, házi segítségnyújtás) minden telepü-lési önkormányzat számára kötelezően biztosítandó feladat. Azonban a kapacitások egyenlőtlenül oszlanak el: van település, ahol az idősek 80%-a számára biztosított az ellátás, máshol csak néhány százalékban. Jellemző az információhiány: az időseknek csak kb. harmada tud arról, hogy mire lenne jogosult. A magyar állam jelenleg a GDP 0,4%-t költi csupán idősek ellátására. Ez az összeg évről évre minimálisan emelkedik. A finanszírozás egyfajta tervgazdálkodás mentén történik: a költségvetési törvényben a normatívák nem az ellátások valódi működési költségeihez kötődnek. A gondozási deficit egyre jobban növekszik. A professzionális gondozók száma csök-ken, mivel a szociális területen a legalacsonyabbak a bérek az egész nemzetgazda-ságon belül, így a betöltetlen álláshelyek száma 2010 óta folyamatosan nő. A pro-fesszionális gondozók átlagéletkora 50 év körül van, hamarosan tömegesen fognak nyugdíjba vonulni. Egyre több pozíciót szakképzetlen közmunkások töltenek be. A felnőtt családtagot ápoló családi gondozók becsült száma 400-500 ezer fő. Közülük mindössze nagyjából 20 ezer fő kap alanyi jogú ápolási díjat, sokan nem is tudják, hogy jogosultak lennének az ellátásra. A családi gondozók száma alacsony európai összehasonlításban és számuk csökkenését több dolog vetíti előre: egyre több idős-nek nincs már élő gyermeke, illetve sokan vándorolnak ki, valamint nő a válások száma. A következmények jól látszanak: ha az állam nem értékeli át a saját szerepét a gon-dozási krízisben, egyre nagyobb számban maradnak majd a rászoruló idősek ellátás vagy bármilyen gondozói segítség nélkül.