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Seeking long-term care in old age

Overcoming the Barriers Within Fragmented Policy Frameworks

Datos Bibliográficos

ID7146293
AutoresEster Gubert (0009-0005-5068-3836, University of Trento, autor de correspondencia)
Año2025
Volumen45
Número12
Páginas2625-2650
Fecha de publicación2025-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaAgeing and Society (JOURNAL)
Identificadores de la revistaISSN: 0144-686X • E-ISSN: 1469-1779
EditorialCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0144686x25000169
OpenAlexW4412649173
IdiomaEN
Referencias citadas37

Understanding the process of seeking long-term care (LTC) in old age helps identify what contributes to delays and inequalities in accessing it. Current research highlights the roles of individual and policy factors, but pays little attention to how these factors interact. This qualitative study aims to fill this gap by identifying facilitating factors and mechanisms in the initial approaches to LTC policies. It examines care-seeking in two towns in northern Italy, where a demand-based approach, high fragmentation and poor coordination pose significant challenges. In a bottom-up approach to policy implementation, the experiences and perspectives of both care-seekers and professionals are integrated. Indeed, the data collection (April 2023–May 2024) triangulates 100+ hours of participant observation and semi-structured or vignette-based interviews. The study finds that care-seeking entails three interrelated steps: recognising care needs, being willing to receive LTC, and reaching an entry point. At each stage, three mechanisms operate at intrapersonal and interpersonal levels and can be promoted by LTC policies to facilitate care-seeking, especially for those experiencing barriers. The mechanisms are (1) taking the initiative to raise awareness of care needs and share information about available solutions; (2) fostering trust between professionals and care-seekers, who often rely on confidential relationships to discuss care arrangements; and (3) combining primary information with tailored guidance on the local offer, enabling care-seekers to make informed decisions. The findings provide actionable insights into policies and practices that facilitate care-seeking, and offer a conceptual framework that explains the driving factors behind this process and its mechanisms

Long-term care · Physics · Term (time) · Healthcare innovation and challenges · Intergenerational Family Dynamics and Caregiving · Medicine · Nursing · Psychology · Social Policy and Reform Studies · Gerontology

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