In the 1970s, long-term care regimes in industrialised countries differed according to the welfare state regime employed in the nation states. However, all of the institutionalised care regimes rested on the assumption that women care for elderly people in their families without any payment. Due to the rise in female labour-force participation, this assumption has not held true since the 1980s. Thus, an explosion of costs for the growing group of elderly people in need of care forced major shifts in long-term care policies in most of the countries during the last three decades. New forms of formal, semi-formal, and informal care arrangements have been institutionalised and culturally adopted. The study reported here examines changes in care policies in selected industrialised countries. It will specifically focus on whether or not a divergence or a convergence of institutional changes in the provision of long-term care regimes in industrialised countries can be observed during the period 1973-97.

The report of the study is organised as follows. First, the theoretical approach and the selection of countries are presented. Then the policy changes in the provision of care are examined. Finally, the findings are evaluated.

Welfare mix approach and welfare state typologies

To identify institutional changes in the provision of care, Evers (1990) developed an analytical tool kit to examine changes in the so-called ‘welfare mix’ (see also Gershuny, 1983; Rose, 1985). He defined the provision of welfare as a triangle consisting of the market economy, the state, and households: the welfare mix. While the economy and the state provide formalised care in the public sphere, households are classified as informal care providers and are located in the private sphere. Evers's contribution to comparative analyses of the provision of welfare and care was to pull the dimension of households into the economic discourse. Thereby, he opened up the possibility of examining institutional changes, or, as he put it, policy transformations in the provision of care (see also Evers, 1994). Evers and several other researchers have conducted large-scale scientific projects which identified changes in specific national welfare mixes (see, for example, Glendinning and McLaughlin, 1993; Evers et al, 1994b).