Long-Term Care and the State-Family Nexus in Italy and Japan—The Welfare State, Care Policy and Family Caregivers

Abstract

This study aims to identify the state–family nexus in long-term care (LTC) provision for older adults in Italy and Japan which have been considered to be a familialistic welfare state and the most ageing societies in the world. Based on the more developed theoretical approach of the familialism–defamilialization continuum of care, represented by Saraceno (2016), the public policy systems as well as the LTC provision and the work–LTC reconciliation of family caregivers in particular, were compared between Italy and Japan. While both countries have lower level of institutional care, and particularly high proportions of family caregivers with relatively heavy care burdens, the share of cash-based and home care as well as the age range and family relationship of family caregivers significantly differ. Focusing on the peculiarities of LTC that the state–(market)–family cannot always be clearly separated, this study identified that the size of public expenditure, i.e., the role of the state does not immediately lead to a defamililization of care. This can contribute to the policy making for care provision and work–LTC reconciliation in several countries that will become super-aging societies in the coming decades.