Care for older people in three Mediterranean countries : discourses, policies and realities of de-institutionalisation

Abstract

This chapter seeks to shed light on de-institutionalisation and the way people are ‘ageing in place’ in Mediterranean countries, based on case studies developed in the context of the COST Action IS1102 SO.S. COHESION – Social services, welfare states and places. Israel, Malta and Spain are chosen to represent diversity in size and demography, but also in culture, religion, history and sociopolitical context. De-institutionalisation can be defined as a policy emphasising care in or by the community rather than care within an institution, but it also refers to the prevention of institutional placements (Bachrach, 1976). Although the de-institutionalisation movement was mobilised by criticism addressed at mental health institutions, it expanded to also include the care of older people, children and persons with disabilities (Lerman, 1985; EEGTICC, 2012). The concomitant need for an expansion of appropriate community-based services makes de-institutionalisation an important object of study (Bachrach, 1976; Fakhoury and Priebe, 2007; EEGTICC, 2012).