Informal Care Regimes: the Case of Rural Greece

Open Journal of Social Sciences, 2021, 9, 352-363 https://www.scirp.org/journal/jss ISSN Online: 2327-5960 ISSN Print: 2327-5952 Informal Care Regimes: The Case of Rural Greece Ekaterini Ntaflou1,2 1Local Government, Social Policy and Information and Communication Technologies, Athens, Greece 2Panteion University of Social and Political Sciences, Athens, Greece How to cite this paper: Ntaflou, E. (2021). Abstract Informal Care Regimes: The Case of Rural Greece. Open Journal of Social Sciences, 9, Society’s gradual ageing has significantly affected the need for improvement 352-363. of the care services for the elderly and the people with disabilities. This study https://doi.org/10.4236/jss.2021.91026 aims to understand mechanisms of informal provision of services, the facili- Received: December 22, 2020 tators, and barriers for such practices on this adaptive mechanism in rural Accepted: January 23, 2021 areas in Greece. The baseline of this article is a field study that was conducted Published: January 26, 2021 in villages of two remote municipalities of Greece. The article comparatively analyses in the place of residence differences as a factor of conformation of a Copyright © 2021 by author(s) and Scientific Research Publishing Inc. unique care and support regime that is offered to the elderly and disabled people. This work is licensed under the Creative The article identifies regional patterns and explores implications for resident’s Commons Attribution International ability to access social welfare and the health market. The article contributes License (CC BY 4.0). by incorporating the special characteristics of place of residence in the analysis http://creativecommons.org/licenses/by/4.0/ of informal welfare regimes. Open Access Keywords Elderly, Disabled, Regimes, Reinforcement, Local Community, Informal Care Regimes 1. Introduction The ageing of society is leading to significant reforms in long-term care policy and systems in many European countries. The ever-growing ageing of the population makes the Greek healthcare system as the most European healthcare systems operate based on the demand for long-term healthcare services. This drives these systems to financial problems, especially, during periods of abatement of state benefits and other fiscal downscales. The interest in the need for long-term care (LTC) for the ever-growing number of the vulnerable population (elderly and disabled) has encouraged the search for solutions. Solutions that will make the DOI: 10.4236/jss.2021.91026 Jan. 26, 2021 352 Open Journal of Social Sciences E. Ntaflou financial sustainability of the care system possible and they will also create a bet- ter balance between offer and demand of care. This raises the question as to whe- ther the volume of informal care will increase in the years ahead. This question is even more pertinent in the light of a widely acceptable argu- ment concerning the informal care regimes is that informal care is an element (Hoffmann & Rodrigues, 2010; Broese van Groenou & De Boer, 2016), an often invisible “pillar” of our welfare systems (Boll et al., 2018) that is formed by the social background of each country (Polese et al., 2014; Hrzenjak, 2012). This mainly happens as the “perceivable duty” for care varies among countries (Naiditch et al., 2013). Drawing on the definition of Kröger and Yeandle (2013: p. 13), by “informal” or “family” carers, we refer to “someone providing care based in a relational, af- fective or neighbourly context to a person with care needs arising from disabili- ty, long-term or terminal illness, or frailty in old age”. The informal care model starts with the notion that someone in the social network is in need of care. To what degree the care provided depends on several factors (care recipient, care- givers). As such, the provision of informal care is depicted as a process in which factors of both care recipient and caregiver are intertwined (Colombo et al., 2011). The concept of informality nevertheless is not new in Social Policy. On the contrary, it represents an important element of Social Policy and of the equiva- lent informal welfare policies. Quite often, it has to do with the main (informal) care that people in need receive and it is comprised of state-based and residual family-based systems. In spite of the unavoidable different perception of the term of informality by both those who are responsible for the creation of policies and those who belong in academia, there is a wider and more discerning prospect that sees informal cares as adjuvant, interdependent with the formal process of care that is mainly considered as family’s responsibility and continues within the local community. Based on this background, Townsend’s theory connects the informal Social Policy to the overall (in)effectiveness and legality of the state. As noted by Town- send (Townsend, 1979), the term “culture of informality” further undermines the state’s ability to provide effective public services. This is partly related to the residual social welfare approach of the state. 2. Problem Statement In Greece, since the 70’s, public policies and programs promoted a sense of greater responsiveness that was coming from informal regimes and, mostly, from the families members. Many of these features relate to different measures or dimensions of informality and indeed, are reflections of a systemic failure. Among those features, we have • low coverage of many social insurance schemes. • low-quality regulation that increases bureaucracy. DOI: 10.4236/jss.2021.91026 353 Open Journal of Social Sciences E. Ntaflou • low-quality public provision of many social services (such as health care or education). • low levels of trust in the state. The establishment of a general framework for the analysis of the informal social protection networks of the rural population of Greece is reflected in the identification of mainly two main concerns. These include: addressing the social service needs of vulnerable populations and how vulnerable populations adapt to the needs and difficulties of accessing social services. Realizing that there are objective and subjective factors which determine welfare access, the analysis argues that the organizational structure of society and the mentalities and values associated with it reflect the gaps of the official state. The scientific analysis of the objective difficulties of access to goods and social protection services to a certain extent in Greece was followed by a macro-struc- tural approach (Petmesidou & Mosialos 2006). The interest was focused on the studies of Getimis and Petrinioti (2003), and Psimmenos (2009) on the deficit on benefits but also on informal practices. From the scientific findings of the above studies, what basically emerges is that access to social goods and services is determined by two important dimensions of social protection. These include: liv- ing and working conditions (demographic and social characteristics, habits, values and expectations) and service conditions. These different concepts about informal care are connected to concepts of value and the ethics of each country as well as the financial background of the welfare state and the degree of the generosity of the provided benefits. According to studies, these benefits affect the “structure of care” which varies among the different regimes of social care and among countries which have different types of a welfare state (Kaschowitz & Brandt, 2017; Frericks et al., 2014; Larsen, 2005; Serrano-Pascual, 2007). In this sense, the financial parameter forces the informal care regimes and, mainly, the family members (family) to deal with the biggest part of the care that is required for the vulnerable population (Brandt, 2013). According to European studies (Courtin et al., 2014; Rutherford & Bu, 2017) depending on the country, the informal care may be provided by: 1) adults who care for their family members, neighbors or friends, 2) pensioners who care for their family members, neighbors or friends, 3) paid non-professional carers who replace or complement the care that is provided by the family. Informal care regimes belong mainly to the immediate environment of the elderly and disabled people. They manage the coverage of their daily health and care needs which could potentially restrict the independence of elderly and disabled people and their ability to stay healthy and socially active. 3. Objective of the Study The main objective of this study was to examine the significant of informal care regimes in isolated and mountainous areas which are characterized by the low population, the disarticulation of the fabric of society and, therefore, of the fam- DOI: 10.4236/jss.2021.91026 354 Open Journal of Social Sciences E. Ntaflou ily itself, and the problems of accessibility. 4. Significance of the Study To improve on the capability of health care systems and local government rural information and knowledge about social support with local agencies—mainly informal and voluntarily—has to be utilized by local government and health care managers. Hence, this study determined their present level of access to and uti- lization of agricultural information and knowledge and examined the socio-eco- nomic advancements, the structure and the duration of the social services that transfer the care from the official bodies to the community and to the personal care are particularly important. It identified the needs of the elderly and disabled people who live in remote and inaccessible rural areas and the constraints they face to meet their needs and reduce their problems. It also determined the characteristics and the effect of the informal regimes in attainment of goals that concern each person, especially those who face difficulties due to their physical debilities. 5. Hypotheses The following hypotheses were tested: H1: Significant relationship exists between the informal care regimes offer services on a frequent and emergency basis to the elderly and disabled members and the rural and isolated villages.

Load more