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Teppo Kröger and Angela Bagnato

Provisions and patterns of care for older people have recently undergone significant change all over Europe. This chapter maps the general directions of change in long-term care in different parts of Europe during the early twenty-first century, based on information reported in working papers produced by national teams in the course of the COST Action IS1102. The chapter covers 11 European countries, representing the Nordic countries (with Denmark, Finland, Iceland), Central/ Central-Eastern Europe (with the Czech Republic, Germany, Slovakia) and the Mediterranean region (Greece, Italy, Malta, Spain), plus the United Kingdom. Data-driven reading of the working papers helped identify five key dimensions of policy developments: (1) decentralized care–centralized care; (2) social care–health care; (3) outsourcing–in-house provision of care; (4) home-based care–institutional care; and (5) formal care–informal care. The chapter reports recent and ongoing change along each of these dimensions in different parts of Europe. It concludes that the main directions of change are: from the central state to the local level, from public provision to for-profit services, from institutional care to home care, and from formal care to informal family care. Altogether, these developments imply that governments in Europe seem in general to be trying to reduce their responsibilities for care of their older populations.