Formal and family care of older people in England and Italy: a cross-national analysis of ideals and practices

Background. Since the 1990s many European countries have undertaken extensive reforms in long-term care for older people in response to concerns over ageing population and the emergence of ideas of neoliberal inspiration about public policy. As a result, elder care policies have conveyed new messages about what constitutes appropriate care in old age. However, individual views of, and attitudes to, such messages are far from granted.
Aims. The study is a comparative analysis of care policy for older people in England and Italy. It aims to investigate a) patterns of convergences and divergences in policy developments and their implications for the cultural view of care endorsed by policy-makers; b) the way in which individuals feel about, and react to, the normative messages embedded in public policy when it comes to tackling the care needs of a frail older relative.
Methods. A first strand of the study reviews policy documents and literature to examine developments in care policy and their interconnection with trends in broader welfare policy. A second strand of the study provides insights into family carers’ views of, and attitudes to, current trends in national and local policies through a qualitative comparative case study analysis of the dynamics of policies, practices and cultures of care in Leeds (Northern England) and Bologna (Northern Italy).
Outcomes. Elder care policies, and the normative messages they convey, have been partly similar between England and Italy since the 1990s. However, the few similarities have been the common arrival point of different pathways. In both countries public policy envisages a model of shared responsibilities between state and family, but the normative messages behind state intervention are challenged by family carers’ views, experiences and practices of care, with traditions and well-established cultural trends concerning care and welfare being an important issue.