1. Identity of Long Term Care
INTERLINKS research findings have shown that long-term care (LTC) as a defined concept is only beginning to emerge and is placed at the junction between health and social care. In some countries LTC is taking shape as an incipient system, at times with a growing formal identity. Everyday care, however, which is provided on an informal basis to older people with long-term needs, is evident in all countries.
To improve LTC in Europe, it is important to find and highlight any systematic approaches that define LTC as a single entity or at least as a specific area of social risk. These approaches can be on either the systems level (eg national governments’ key papers, legal guidelines and principles, the regulation of migrant caregivers) and on the organisational level (eg mission statements addressing links and interfaces, civil society initiatives, educational aims).
Furthermore, basic values and rationales in given societies are essential preconditions for understanding political and societal choices in LTC and how LTC is carried out in everyday practice.
1.1 Values
Values are important for shaping political, organisational and individual choices in LTC. By organisational values we mean beliefs and ideas about what kinds of goals for the organisation workers should pursue. Organisational values tell workers about what sort standard or norms of behaviour are acceptable to achieve these goals. In addition, values can be formed in terms of outcomes for users. Organisational norms, guidelines and expectations about workers are developed from these values.
Examples must describe at least one of the following key issues:
- How key principles that characterise LTC are expressed; what values dominate for which stakeholder perspectives? (eg economic and quality perspectives, citizenship)
- Whether there are sets of values that are shaping political, organisational and individual choices in LTC (eg through surveys of older peoples’ specific needs for care and support)
- How informal care and/or family ethics are addressed in legislative frameworks
- How issues of dignity, quality of life and empowerment are described in policy papers
- How values relating to prevention and rehabilitation are considered
- How values embrace the diversity of users and carers (according to gender, culture and social inequalities) and support the specific needs of hard-to-reach groups
1.2 Mission statements
A mission statement is a formal, short description of an organisation’s fundamental purpose. It should answer the question, “Why do we exist?” and spell out the overall goal for the organisation. Examples of mission and/or vision statements describe how LTC is represented and must include at least one of the following key issues:
- Organisations that explicitly address problems at the interfaces between, for example, formal/informal and health and social care, prevention and rehabilitation or the use of migrant care workers
- A description of how the problems are addressed and what particular factors distinguish an organisation as a ‘LTC organisation’, rather than a health or social care organisation
1.3 Organisational definitions
This sub-theme includes examples from innovative, LTC-oriented organisations that provide specific definitions and concepts of LTC in practice. Examples must include at least one of the following key issues:
- How LTC is defined within or between organisations
- How health care providers define their purpose in relation to LTC (cure vs. care; needs vs. supply; expectations vs. preferences)
- How clients are defined and positioned
