Framtidens boformer for eldre: perspektiver og eksempler fra de nordiske land
In: Nord 1999:26
19 Ergebnisse
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In: Nord 1999:26
In: European psychologist, Band 8, Heft 3, S. 200-207
ISSN: 1878-531X
Why has aging and old age attracted so little interest in psychology? This article explores the resistance to aging perspectives, and the struggle to have gerontology recognized, in basic disciplines like psychology and sociology. Aging may, in fact, be a most appropriate "laboratory" for research on individual competence and motivation, considering the many stressors and the great diversity in later life. Findings from Norwegian and German studies on age-related changes in personality and intellectual functioning indicate a need to shift the focus from variables to individuals and study the various pathways of psychological aging. What type of trajectories are hidden behind the mean trends? This perspective may help us move beyond the often trivial and technical study of variables into the joys and tragedies of real lives, and can serve as a guideline for a fresh agenda for psychological aging research in Norway.
In: European psychologist: official organ of the European Federation of Psychologists' Associations (EFPA), Band 8, Heft 3
ISSN: 1016-9040
In: Soziale Gerontologie und Sozialpolitik für ältere Menschen, S. 408-424
In: Ageing international, Band 24, Heft 1, S. 51-62
ISSN: 1936-606X
In: Journal of European social policy, Band 2, Heft 1, S. 33-47
ISSN: 1461-7269
Scandinavia has developed a wider definition of welfare policy, and a more active state involvement, than in probably any of the other western nations. Are the values underlying the Scandinavian model now under stress? Is Scandinavia changing, and now converting to other ideals? Are the Scandinavian states becoming less ambitious? Is Scandinavia becoming less committed to universality, and increasingly characterized by distribution according to contribution (social insurance) and more strict need assessments (residuality)? Are benefit levels becoming less generous, and are the Scandinavian populations themselves growing less committed to their welfare states? These questions are discussed in the context of current trends in welfare policies towards older people in the four major Nordic countries.
This report presents the results of an innovative and national study on Lifecourse, Generation and Gender (LOGG), including the responses of 10 570 Norwegians between 18 and 79. The aim of the study was to gather information about central transitions in the life-course. The present report is one of two reports from the LOGG Health and Care project, which is financed by the Norwegian Ministry of Health and Long-term Care. This report describes social variation in health and health-related behaviour. A life-course perspective is used throughout the report and underlines the importance of time in relation to health and health-related behaviour, whether this concerns ageing, life phase or cohort. Results of the report provide pointers for further analyses within the study, including longitudinal analyses. Chapter 1 presents the background for the project and the research questions. Chapter 2 explores age-related patterns of social variation in health and whether such patterns differ across health domains. Chapter 3 presents social variation in health-related behaviour and explores the interrelation between different types of health problems and health-related behaviours. Finally, Chapter 4 provides a description of social conditions during childhood and their impact on health and health-related behaviour in adult life. Social variation in health (Chapter 2)The results of Chapter 2 indicate that social inequality in health, as measured by educational attainment, can be quite large and is related to both life phase and gender. The strength of these relationships depends upon which health domain is considered: general health, mental health, or functional limitations. Social inequalities in general health and functional limitations are largest in mid-life, which is in line with the accumulation of disadvantages hypothesis. Social inequality in mental health is largest among younger age groups, and especially in women. Thirty-seven percent of young women with basic education and 16 % of young women with highest levels of education report depressive symptoms. An important question is whether these large social inequalities are characteristic for the life stage of young women and disappear with ageing of this cohort, or whether high rates of depressive symptoms persist or even exacerbate in later years. Scores for measures of general health tend to stabilize among the oldest respondents (70-79 years). Selective attrition is one likely explanation, but changed expectations regarding health may also contribute to more positive responses to such general measures. The sharp increase in functional limitations among the oldest with high education may be interpreted as postponed morbidity. One in three people aged 18-66 years has a longstanding illness, and half of these have a limiting longstanding illness. Within this group we find smaller social inequalities in the different health domains compared to the sample as a whole. Nevertheless, high education also seems to protect those who relatively early in life are confronted with a limiting longstanding illness. Social variation in health-related behaviour (Chapter 3)The results of Chapter 3 underline that health-related behaviour is strongly related to age and life phase. Increasing age is associated with increasing use of medications. However, the gender gap in use of for example painkillers and sleeping medications increases with age, and so does social inequality. Between age 50 and 66, 31 % of women with lowest educational attainment and 12 % of women with highest educational attainment have used painkillers during the last month. These patterns partly reflect social differences in health and functioning. In addition they may reflect differences in lifestyles between more and less educated people in this particular stage of life. After age 50, there is a noteworthy risein social inequality in regular alcohol consumption and in yearly visits to the dentist. Regular alcohol consumption particularly increases among seniors with high levels of education. Yearly visits to the dentist are declining particularly in elderly men with lower levels of education. Large social inequality in daily smoking is found in young and middle-aged adults (age 30 to 49). Differences between those with highest and lowest educational levels are up to 30 percentage points. Health promotion and disease prevention initiatives have especially targeted smoking and physical activity. Results from the present report suggest that these initiatives may need to be adapted to young and middle-aged adults with lower educational levels. Health is a major precondition for physically activity, in particular below 67 years. This is also the case for daily smoking, obesity and use of health care services. The direction of causality can go both ways. Consequences of unfavourable health-related behaviour typically accumulate over time and may first be observed in later life. As we live longer, it is important that health promotion and disease prevention initiatives continue to have focus on health-related behaviour early in life. Social conditions during childhood and their implications for health and health-related behaviour (Chapter 4)Chapter 4 describes the impact of childhood social conditions (parental divorce, father's education and school problems) on health and health-related behaviour in adult life (physical limitations, mental health, daily smoking and obesity). Parental divorce during childhood has a clear negative impact on mental health and daily smoking in adult years, even after controlling for the effect of own education. However, high educational attainment of the father may function as a buffer against the negative effects of parental divorce in childhood. Father's higher educational attainment is also associated with fewer physical limitations and less daily smoking. However, this is an indirect effect, mediated by own educational attainment. Among women, higher educational attainment of the father is associated with lower levels of obesity. Between 30 and 39 years of age, 23 % of the women with less educated fathers were considered obese compared to 9 % among women with higher educated fathers. This direct effect was somewhat reduced, but persisted, even after taking own educational attainment into account. Seen from a life-course perspective, these results may imply that the risk for obesity accumulates particularly in women with less educated fathers. School problems pose a risk factor for physical limitations, mental health and daily smoking in adult life. In general, the impact of social conditions during childhood is less strong among the oldest respondents (60-79 years). The general and retrospective nature of the item measuring problems at school is particularly vulnerable to measurement bias, which may differ across cohorts. Nevertheless, findings indicate more school problems during childhood in younger than older cohorts. This, together with their impact on health and health-related behaviour in adult life, may imply that school problems are an increasing public health problem. ; Rapporten tar for seg sosial variasjon i helse og helseatferd i ulike aldersgrupper. Utgangspunktet er en ny og landsdekkende undersøkelse om livsløp, generasjon og kjønn (LOGG/NorLAG). Analysene av variasjoner i helse og helseatferd, og av de mekanismer som former dem, gir viktige innspill til politikkområder som aktiv aldring, nedbygging av funksjonshemmende barrierer, framtidige omsorgsutfordringer og utjevning av sosiale helseforskjeller. Rapporten gir en første beskrivende analyse av helse og helseatferd for ulike sosiale grupper og alderstrinn, og resultatene brukes som en pekepinn for videre arbeid med materialet, blant annet longitudinelle analyser. Undersøkelsen viser at det er til dels store forskjeller i helse som er knyttet til livsfase og kjønn. Også helseatferd endres gjennom livet, og endringene kan variere med kjønn og livsfase. I rapporten diskuteres det videre hvordan sosiale forhold i barndommen henger sammen med helse og helseatferd i voksen alder. Resultatene tyder på at grunnlaget for sosial skjevhet delvis blir dannet i barndommen, og at de forsterkes gjennom livsløpet.
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Summary The report focuses on solidarity between adult generations, more specifically what responsibility adult children have towards older parents, how responsibilities should be divided between the family and the welfare state, and how the two impact on each other. Data was collected through the European comparative study OASIS, Old age and autonomy - the role of services systems and intergenerational family solidarity. The project was financed through the EU fifth framework program, and carried out in Norway, England, Germany, Spain, and Israel. Individual level data were collected via parallel surveys (interviews) among the urban populations aged 25 and over in each of the five participating countries. National samples counted about 1 200, around 6 100 in total. The older participants (aged 75+) were oversampled to represent around 1/3 of the samples.The project was motivated by the assumed threat to family solidarity in late modern and individualist society (Chapter 1). Of particular interest is the relationship between the family and the welfare state. What is a reasonable and sustainable balance? These questions need be studied in context, hence a comparative approach was seen as appropriate. The countries were therefore selected to represent different family cultures and welfare state regimes. They are located along a north-south axis, which according to Reher (1998) divides European families into a southern more collectivist form, and a northern more individualist type. The five countries also represent different welfare state regimes; the social democratic (Norway), the liberal (England, and the conservative-corporatist (Germany), to stay within the Esping-Andersen typology (1990). Spain has as yet a less mature welfare state, while the fifth country, Israel, is a mixed model.The macro conditions of the countries are assumed to be reflected on the invidual and interpersonal (family) levels. Preferences and practices are assumed to be more or less congruent with the already established traditions, and to be more conform for the older than for the younger generation. The present balance is assumed to be fluid and under pressure from demographic and social change in all countries, but more so in countries that are later in these developments and are now confronted with more rapid changes. These assumptions are in OASIS explored in the strength and character of intergenerational family solidarity, and in the ideals and realities of the family-welfare state interaction.Welfare states differ in the responsibility they ascribe to families (Chapter 2). Some put the family in a dominant position, others assume that the welfare state should protect against dependency upon the family. The OASIS-countries are differently located along this dimension, hence they represent different opportunity structures for family life and elder care. They are facing similar challenges, but are inclined towards different solutions. Germany and Spain tend to favor familistic solutions, and give the state a subsidiary (Germany) or even a residual (Spain) role. They have legal obligations for adult children towards older parents and low levels of services on areas that are by tradition a family responsibility, like long-term care. England and Norway have no legal obligations between generations and higher levels of services on traditional family areas, in particular in Norway. Israel is a mixed case, with legal obligations as in Spain and Germany, but also with rather generous service levels.Are these patterns reflected in public opinion and personal preferences? Do people support the established policies, or do they push for change? Of interest is also to investigate consensus and contrasts in attitudes within the five countries, for example between women and men, the younger and the older. Knowledge about actual help provision is important, but so also is knowledge about norms and attitudes because people tend to act accordingly if opportunity allows it.The intergenerational solidarity model (Bengtson & Roberts 1991) is employed as a research instrument and measures solidarity along six dimensions - structural, associational, consensual, affectional, functional, and normative solidarity. Ambivalence has more recently been introduced as an alternative perspective (LöƒÂ¼scher & Pillemer 1998). Intergenerational relations are seen as inherently ambivalent and characterised by mixed feelings and contradicting expectations that family members need to cope with. These adaptive changes may have been misinterpreted as a breakdown of family solidarity in stead of a change in how solidarity is expressed.Affectional solidarity (Chapter 3) is considerable. Both parties say they feel very close, but parents more so than children. Conflict levels are low as seen from both sides of the relationships, while both parties - and in particular the children - allow a difference of opinion without this being seen as a threat to the relationship. The presumably tighter spanish family shows primarily in structural and associational solidarity. Generations live closer and have more often contact in Spain compared to the more northern countries. This is mainly explained by the higher co-residence rates in Spain, but shared living is often enforced more than chosen, and is then more likely an indicator of (lack of) opportunity than of solidarity.Exchange of help and support (functional solidarity) is substantial in all five countries, and not less so in the northern family (Chapter 3). Exchanges are integral parts of daily life of nearly any family, but roles and resources change over the life course. Older people tend to be in the receiving end, but act also as providers of support. Starting out from the adult child perspective, the findings show that most adult children have provided one or several types of support to older parents during the last year. Emotional support is the most frequent form of support, followed by instrumental help. Only few children provide personal care to older parents, probably because few parents are this frail, and if so, they may already have moved to an institution. Adult children are as a general rule the net providers in the exchange relationship to older parents; they give more than they receive. Older parents provide first of all emotional support to adult children, and in some countries (Norway, Germany, Israel) also money. Instrumental help is flowing upwards in the family line, financial support flow downwards if and when pension levels allow it.Normative solidarity (Chapter 4) is indicated by the support for filial obligation norms; the extent to which adult children are obligated to help their older parents. The majority support such norms in all five countries, but more so in Spain and Israel than in Norway, England, and Germany. This trend is consistent with Rehers (1998) suggestion that the southern family are tighter than the northern. The main impression is, however, that normative solidarity is substantial also in northern countries, even in a universalist welfare state like Norway. This is even more so as the samples were drawn from large cities, and do not include smaller towns and rural areas which may be assumed to be even more familistic. Hence, neither urbanisation nor welfare state expansion seem to have eroded filial obligations.The focus in Chapter 5 is on what people find is a reasonable balance of responsibilities between the family and the welfare state, and what their personal preferences are. Public opinion is found to vary considerably between the countries. The welfare state is seen as the main responsible in Norway and by a (smaller) majority also in Israel. A more even split is favoured in the other three countries. A common trend is that the majority in all five countries favours some form of complementarity between the family and the welfare state, but the complementarity takes different forms. The welfare state is assumed to have the major responsibility in Norway and Israel with the family in a supplementary role. Itö''s the other way around in Germany and Spain, with England in an intermediate position. Attitudes are more or less congruent with the actual policies, but public opinion leans more heavily towards a welfare state responsibility than is presently implemented. The contrast between ideals and realities is greater in low-service countries, implying a greater tension between policy and opinion in these countries.Gender differences are small; hence the female dominance in actual care provision is more likely imposed upon them, not chosen. Age differences are also modest. Older people are not more traditional (familialistic) than are the younger. Spain is an exception, while Norway has high degree of consensus in these matters across gender and age. The older generation is in fact more inclined to push responsibilities on the welfare state than are the younger. Personal preferences lean even more towards services than do the more general attitudes. The great majority of Norwegians state a preference for services over family care if they should come to need help in old age. A corresponding majority would prefer institutional care over living with a child if they could no longer live by themselves. Preferences are more moderately biased towards the welfare state in three of the other four countries. Spain stands out with a majority in favour of family care, but only among the older generation.Chapter 6 analyses the actual distribution of help to elders in need. The family and the organised services are the dominant sources of help, but in different combinations. Families are dominant on all leves of needs in Spain, while services - and then mainly public services - are the major source of help among the most needy in Norway. The total help rate (from all sources) is higher in a high-service country like Norway than in a family dominated system like Spain, while the volume of family care is only moderately lower in Norway, indicating that service systems and families tend to supplement rather than substitute each other. There is little or no support in these trends for the idea that older people are diserted by their families and pushed over on services as a secondary option. Family solidarity need not be threatened by alternative or complementary services, and each party may have qualities that are not easily replaced by the other. Hence complementarity is more likely than substitution.Considering that affection and exchange levels are rather substantial in five otherwise different countries, they indicate that solidarity is general and considerable although not universal. While country differences are moderate in the more general features of solidarity, they are far larger in the more concrete attitudes about how policies and services should be organised. If this is a valid observation, then intergenerational family solidarity may have a rather stable and general character, but find different expressions in practice when circumstances and conditions change. This suggestion indicates a need to clarify what should indeed be ment by solidarity. We have therefore in the concluding Chapter 7 conducted a series of factor analysis in order to explore the solidarity concept and model. The findings give conditional support to a simplified variant of the solidarity model. A general finding is a four factor solution. Affection comes out first and includes consensus. Conflict comes out next as a distinct factor. Third is a joint factor for structural and associational solidarity, while giving and receiving support (functional solidarity) is the fourth factor. Normative solidarity is in most cases not included in any of these factors, and is apparently a distinct aspect of intergenerational relationships that may be combined with different ways of relating to each other.Family life has been, and to some extent still is, structured by material necessities and enforced duties which makes it difficult to separate the truly solidary motivations from external pressures. These are among the reasons why it is difficult to compare families across time and cultures. Solidarity may be easier to observe and separate from external pressures today than in earlier times, but the mechanisms and processes that have produced the solidary patterns may have become more complex. ; Rapporten belyser solidaritet mellom familiegenerasjoner, nærmere bestemt hvilket ansvar voksne barn har for eldre foreldre, hvordan ansvarsdelingen mellom familien og velferdsstaten er, og hvordan den etter befolkningens syn bør være. Ligger det en trussel mot familiesolidaritet i framveksten av velferdsstaten og økt individualisering? Rapporten tar også opp hvordan familien og velferdsstaten påvirker hverandre, og hva vi i mer teoretisk forstand skal forstå med familiesolidaritet. Dataene ble samlet inn gjennom det europeisk komparative prosjektet OASIS, Old age and autonomy - the role of services systems and intergenerational family solidarity. Fem land med ulik familiekultur og velferdspolitikk deltok i studien, Norge, England, Tyskland, Spania og Israel. Dette gir muligheter for å studere forholdet mellom familie, velferdsstat og aldring under ulike betingelser. Et tilfeldig utvalg av storbybefolkningen i alderen 25 år og over ble intervjuet i hvert land, ca. 1 200 i hvert land, til sammen ca. 6 000.
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In: Retraite et société, Band n o 38, Heft 1, S. 15-47
Quelle est la nature des obligations entre enfants adultes et parents âgés dans l'Europe contemporaine? Qu'est-ce qui est perçu comme un bon dosage des responsabilités entre la famille et l'État-providence et par qui les individus préféreraient-ils être aidés s'ils devaient en avoir besoin durablement? Ces questions sont examinées dans une enquête auprès d'échantillons représentatifs de citadins âgés d'au moins 25ans, dans cinq pays : Angleterre, Allemagne, Espagne, Israël et Norvège. Il semble que des normes d'obligation filiale prédominent dans ces cinq pays, mais à des degrés divers. Ces écarts sont encore plus marqués dans les réponses portant sur l'expression concrète de ces normes, et vont ici dans le même sens que les opportunités et politiques nationales. Les obligations filiales ne supposent pas forcément que la famille soit considérée comme l'aidant naturel. En fait, la préférence pour le dispositif d'aide est généralement supérieure au volume des services effectivement fournis, d'où la demande, non satisfaite, d'une plus grande intervention de l'État. En outre, les différences de normes et d'opinions paraissent obéir à des logiques quelque peu différentes, ce qui laisse à penser que les conclusions pour un pays donné ne peuvent guère être généralisées à ceux qui n'ont pas les mêmes traditions familiales ou le même régime d'Étatprovidence.
In this research report, we analyze the planning of thirty Norwegian municipalities concerning long-term care and housing for elderly in light of population ageing. Will Norwegian municipalities give priority to nursing homes or assisted housing in the future? To what extent do the municipalities plan to influence the provision of housing for older persons? These are the central research questions of this report. The empirical backbone of the report are policy plans from thirty local governments – the ten largest, ten medium-sized and ten small Norwegian municipalities. In addition, we draw on interviews in four municipalities and official statistics. Assisted housing, combined with services provided at the home of households, are the vogue of Norwegian long-term care. Most of the policy documents studies in this research project profess to give priority to assisted housing over nursing homes. Nonetheless, nursing homes are arguably still the pillar of the eldercare provided in the municipalities. This will neither change in the short run or (in all probability) in the next twenty years. The role of nursing homes, however, is in a process of change: Most municipalities plan to transform these to provide for short-term needs, and aim at providing care for the elderly's long-term needs through assisted housing and services in private homes. Thus, assisted housing is increasingly a fully-fledged alternative to nursing homes, also in cases where there is need for extensive care services. Analyses of the municipalities' planning work for the provision of housing to the elderly indicates a policy area with unfulfilled potential. For instance, adapting the present housing stock to the needs of older people, or cooperating with construction companies to build privately financed assisted housing, may lead to big savings for the municipalities. However, most municipalities are quite vague when it comes to plans for influencing the quality and quantity of housing directed at the elderly. This may be a product of the current consensus regarding Norwegian housing policy. Since housing is regarded as an individual responsibility, provided by the market, it is only natural that local governments are reluctant to take responsibility for the provision of housing to the elderly. Moreover, the municipalities may be waiting for the state to take financial responsibility in this area. Specific knowledge gaps and ways forward for scholarly research and politics of old age, housing and long-term care are discussed in Chapter 6. ; Rapporten drøfter bolig- og tjenesteplanlegging i kommunene i lys av den forventede veksten i antall eldre. Hva prioriterer kommunene: Sykehjem, omsorgsboliger og/eller hjemmetjenester? Er kommunene bevisst på betydningen av boligpolitikk for eldreomsorgen? Finnes det et eldreperspektiv i boligtilpasnings- og utbyggingspolitikken? Dette er problemstillinger som berører sentrale veivalg i velferdspolitikken i årene som kommer. Rapporten viser at omsorgsboliger og hjemmetjenester fortsatt er på fremmarsj i tråd med eldreomsorgens delvise «boliggjøring» fra begynnelsen av 1990-tallet. Likevel har sykehjemmet fortsatt en sterk posisjon i norsk eldreomsorg. Vi viser også at mye av politikken rettet mot eldres ordinære boligsituasjon har et uforløst potensiale: Mange planer på dette området er i startgropa eller på skissestadiet.
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In: Nordisk østforum: tidsskrift for politikk, samfunn og kultur i Øst-Europa og Eurasia, Band 33, S. 34-53
ISSN: 1891-1773
Abstract: Between generations: Attitudes towards family responsibilities in the East and the West of Europe The article addresses the strength and character of family responsibility norms in Eastern and Western Europe. The strength is measured by the level of support for filial and parental responsibilities (i.e., adult children's obligations towards older parents and vice-versa) and the character is indicated by the priority given to the older or the younger generation. For the analyses, we employ data from thirteen Eastern and Western European countries participating in the Generations and Gender Survey. In general, family norms are stronger in the East than in the West, but it is difficult to establish where to draw a dividing line. The contrast between the two extremes, Norway and Sweden in the north-west and Georgia in the south-east, is striking. The remaining countries line up quite close along the geographical diagonal (from Scandinavia to Georgia). The character of the norms is less clearly distributed – whereas almost all countries in Eastern Europe give priority to the older generation, the picture in the West is more mixed. The results partly confirm earlier conclusions about east-west differences in family responsibility norms, but adding more countries to the analyses has revealed a more complex and ambiguous picture than presented in previous studies.
Population ageing changes profoundly the current balance between generations. Governments are responding with policies to promote later retirement and family care, but these ideals may come in conflict in mid-life when family obligations can be hard to reconcile with employment. Yet we know little about the prevalence of being "sandwiched", and even less about the consequences. This article maps out the prevalence of different forms of family and work sandwiching for the Norwegian population, and explores adaptive strategies and psycho-social outcomes. The analyses are based on data from the NorLAG and LOGG studies (n = 15 109, age 18–84). Preliminary findings indicate that 75–80% of the population are located in-between younger and older family generations in mid-life, the great majority are at the same time in paid work, but comparatively few (8–9% aged 35–45) have both children and parents in need at the same time, and fewer still (3%) are then also caregivers to older parents. Although few in proportion of their age group, they add up to a considerable number of persons. Women are more likely to reduce work in response to family needs than men. Implications of family and work sandwiching for health and well-being are analysed.
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