301. EUROFAMCARE: Review of Family Care in Switzerland
- Author
-
Stuckelberger, Astrid and Wanner, Philippe
- Subjects
Elderly ,Ageing economy ,Healthcare ,Family ,ddc:304.6/305.3/306 ,Generations ,ddc:613 - Abstract
In Switzerland as in most European countries, family care patterns have changed considerably as a consequence of many socio-demographic, eco-nomic and environmental changes during the last decades: lower birth rates, higher divorce rates, higher life expectancy, increased longevity, and unprece-dented increase of professionally active women (Höpflinger and Stuckelberger, 1999, Stuckelberger and Höpflinger, 1996). The family network available for caring is becoming smaller and geographically more distant. First, families have fewer children, thus the number of potential care providers is diminishing, but live longer and healthier with a potentially wider age range of care providers within the family. Although women remain at the centre of providing instrumental and emotional support to older people in Switzerland, a shift can be observed in the family: professional working time sharing witnessed by the raise in the number of women on the labour market, the strong increase in divorce rates or single parents which all gives less time to women for providing care. The care giving pattern within the family relies on the civil status and household composition: in a couple, the main provider of care is the spouse, as in the case of a widow(er) or single / divorced older per-son the children and grandchildren take on an important role. The fact that two to three generations are at retired age at the same time has also created new care patterns within the family: the older person taking care of their older par-ent or / and their grand children. The incentives that the state welfare will put in place to support the supporter financially will have a strong impact on the fam-ily care providers and family relations. Second, the social and geographical mobility of the family networks have also increased through migration (internal and international) and interethnic mar-riages. Furthermore, family care provision has gone through profound changes linked to the complexification of the family and social structure during the last century: higher age at first marriage, higher rates of divorce. The number of family members of different generations living under the same roof has signifi-cantly decreased and the natural family care tradition of caring for the aged at home or in close proximity is diminishing or disappearing, even in remote rural or mountain areas of Switzerland. All those elements show a clear tendency towards the family structure and family relations becoming more complex. Third, the technological revolution is creating new forms of health care sys-tems and communication, which is affecting society, health care professionals and family relations (e-care, tele-care, smart housing, etc.) more and more. This trend is already starting to lead to generation gaps in offer / demand ex-pectations between different health sectors, market constraints but also within the family between generations (European Population Forum, 2004; Stuckel-berger, 2003). Fourth, the economic and care dependency ratio between generations has modified the link ‘family-society' at the structural level: it is not so much the longevity as the population distribution over the life cycle that accounts for the multiple generation family and gives a clearer view of the needs and potential provision of family care. Table 1 gives an overview of the population distribu-tion in a life cycle perspective which very clearly shows the distribution per decade of the relative proportion of a generation needing care or economically dependant on the professionally active population. The percentage distribution per life cycle periods has since 1900 been increasingly tending towards a de-crease in the professionally active population and an increase in the ratio of professionally non active vs. the active population. This socio-demographic factor is one of the keys to the ongoing modification in inter-generational rela-tions and family care and economic concerns of policy-makers: less and less people must provide for the care and economic support of more and more people (Höpflinger und Stuckelberger, 1999; Stuckelberger, 2005; Wanner et al, 2004).
- Published
- 2005