Eldercare policies in East Asia and Europe: Mapping policy changes and variations and their implications

Adequate and dignified care provision for frail elderly populations is becoming an urgent policy issue not only in high-income countries but also in many middle- and low-income ones. The growing demand for eldercare in many countries is driven by rapid demographic ageing as well as by changes in family patterns and gender relations, greater distanciation between generations and institutional and ideational changes in relation to political economy and the meanings and practices of care. This report documents and analyses varieties of eldercare policies, and their readjustments, in East Asia and Europe. It analyses changing social, economic and political contexts and their implications for eldercare and eldercare policies in 10 selected countries – China, Japan, Republic of Korea, Singapore and Taiwan in East Asia and Finland, France, Germany, Spain and the United Kingdom in Europe – that all have in common severe care deficits that will only amplify in the future, given their rapid population ageing, low fertility, rising female employment and increased mobility and distanciation of families. The first two sections of the report describe broad social, economic and political contexts and trace the trajectory of eldercare policies, noting reforms and developments at first the regional and then the country level. The third section examines the impacts and implications of these changing eldercare arrangements and policies for women and families. The two regions are sites of intense eldercare policy reforms, as governments across both regions try to manage the imperatives to address increasing public demand for care, maintain fiscal control over social and healthcare expenditures and respond to changes caused by population ageing and mobility. This has resulted in significant cross-national and cross-regional policy learning, innovations and experimentations, as governments adopt and adjust policy models from other locales to meet their needs. Policymakers in all the countries considered continue to find these developments challenging, with some elderly people and their families, especially women, inadequately supported. The paper argues that despite active policy learning, significant variations remain both within each region and between the two regions, underscoring the importance of local histories, institutions and cultures in shaping policy diversity.