Innovations and Care of the Elderly: The Cutting-edge of Change for Social Welfare Systems. Examples from Sweden, the Netherlands and the United Kingdom

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Abstract
This article is based on an international study which investigated innovations in home care for the elderly in three European countries:Sweden, the Netherlands and the United Kingdom. It is argued that the particular changes taking place in services for the elderly may be indicative of what will happen more generally throughout welfare systems. This is because patterns observed in an area of acute pressure are often precursors of further developments. Welfare systems change first at points of pressure where established policies and solutions are no longer working or cannot be sustained. Innovation and reform become necessary. This is certainly true of social care policies for the elderly in industrial countries. It is no coincidence that in each of the three countries we studied government has commissioned major inquiries into the operation of the care system and that the early 39905 will see the introduction of substantial reforms. We argue that the changes that are taking place, although mediated by particular national traditions and politics, have much in common. They are part of a shift away from the state-dominated post-war welfare settlements towards more diffuse and pturalist forms of social care. The frail elderly, for demographic and etonomic reasons, are in tne front line of this shift to new patterns.