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Blanca Deusdad, Sagit Lev, Charles Pace and Sue Vella

De-institutionalisation of care for older people in Mediterranean countries has not been sufficiently analysed, in terms of policy discourse and implementation. The aim of this chapter is to study and compare both aspects within a cluster of three different Mediterranean countries: Israel, Malta and Spain. Although these countries differ in their historical, geographic and demographic features, they share a number of features. The traditional provision of care by the family has decreased as women’s employment rates have risen and family sizes have shrunk. Despite attempts to counter this through various ‘ageing in place’ policies, in none of the three countries have such attempts managed to fully offset undue institutionalisation due to the lack of family or financial resources, let alone enable the return of older persons from institutions to the community. Despite differences, enough similarities exist to propose a Mediterranean variant of LTC for older persons. This is characterised by ongoing reliance on family care even in the face of rising female employment; by underdeveloped or under-resourced community services; and by growth in private care services including recourse to migrant care labour. These features have implications for older adults who lack family support or financial means, and for the sustainability of care policies in the face of rapid demographic ageing.

Open access

Blanca Deusdad, Jana Javornik, Rosa Mas Giralt and Raquel Marbán-Flores

This chapter explores changes in care policies and how these affect gendered opportunities in the wake of the 2008 financial crisis. It focuses on Spain and the United Kingdom, two national case studies that have very different cultural and policy trajectories. Although legislation and measures supporting parental leave, child care services and care for older people were introduced in both countries in the 1990s and 2000s, austerity measures following the financial crisis of 2008 have disrupted those policy directions. Both countries lack a strategic and sustainable approach to gender equality in care. In Spain, family solidarity mechanisms have resumed, with forced re-familisation and co-habitation. In the United Kingdom, the national deficit reduction plan has cut local government budgets for care services to older people and children. These changes have interrupted the ‘policy transformative potential’ brought about by programmes and legislation supporting care services during the previous two decades. As a consequence, in both countries, women’s access to well-paid jobs and professional development remains a challenge, in the context of insufficient and superficial gender equality legislation.