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In this paper, we analyse the tensions in home-based care when carried out with fragmented and scant resources due to weak public policies, as is the case in Spain. The home-based care model places great strain on families, especially when situations of dependency worsen. It also overtaxes paid caregivers, who work in highly precarious conditions, and stretches the social and health systems, which cannot respond to the demand for resources, all of which have repercussions on family care. Long-term care provision is unequally structured on the basis of gender, class and ethnic/national origin. Our analysis is particularly relevant in light of political efforts to promote the deinstitutionalisation of long-term care by encouraging the ageing at home model and avoiding or delaying nursing home admissions. Without sufficient public resources, the deinstitutionalisation of long-term care will lead to a return of care provision to families. We address these issues within the context of the crisis of care and the contradictions between social reproduction and the changes in the logics of accumulation and dispossession of the capitalist system.

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