Eldercare Service Redesign in Finland: Deinstitutionalization of Long-Term Care

ABSTRACT

Deinstitutionalization is an important trend in the redesign of long-term eldercare in Finland. It refers to a process where traditional institutional care is partly replaced by home care services and the creation of homelike housing units. The first part of this article provides an overview of eldercare service redesign by using national statistics. The second part consists of qualitative analysis of the deinstitutionalization of eldercare. The data consist of 27 interviews conducted among municipal care administrators and is analyzed using thematic and discourse analysis. Main findings show a deep policy change taking place in eldercare deinstitutionalization discourse lying at its center. A distinction between explicit and implicit deinstitutionalization discourse is made. The former clearly states that institutional care needs to be cut back making it possible for all older people to live at home or in homelike housing facilities. Implicit deinstitutionalization discourse is underpinned by comments of a different type, more critical and problem-centered. Within intensive service housing, for instance, fee policy is reformed. The main results include the observation that explicit deinstitutionalization discourse is in line with the national policy aims of putting home first, while implicit discourse deals with hidden or unexpected consequences. The article discusses future research in the conclusion.

KEYWORDS:

• Care policy
• deinstitutionalization
• eldercare
• long-term care
• Nordic model
• policy analysis

Acknowledgments

This research was carried out in the framework of the COST Action 1102 “Social Services, Welfare State and Places,” 2012–2015. We would like to thank deeply all the colleagues and members of the COST Action IS1102 for critical comments. Most importantly, we thank the guest editors, Blanca Deusdad and Charles Pace, for their most valuable comments. We also want to thank the local administrators for participating in our study as interviewees. We are also very grateful to all older adults and caregivers interviewed during our fieldwork.

Funding

The research has been supported financially by the Academy of Finland, Social Insurance Institution of Finland, and the University of Tampere.

Notes

¹ http://www.finlex.fi.