Cash-for care in long-term care for older people: a historical and comparative account

Cash‐for‐care (CfC) schemes involve monetary transfers to individuals requiring care, designed to empower them to organize their own care arrangements. The implementation and utilization of these benefits vary across countries, depending on the amount provided and the specific conditions attached to their use. Beneficiaries of CfC schemes may allocate these funds to compensate informal caregivers, purchase public or private care services outside the family, or supplement their income for expenditures related to their condition. This chapter offers a comparative analysis of CfC benefits to elucidate: a) their relative weight within broader LTC systems and their coordination with home care services; b) the regulatory frameworks governing eligibility, generosity and conditionality in their use. Adopting a new institutionalist perspective, we explore the historical origins and development of these measures, their functional relationship with care service provision, and their regulatory settings. Our approach combines secondary data analysis with the investigation of regulatory documents defining eligibility criteria, benefits levels relative to care needs, and any conditionality in their use. This analysis allows us to construct an analytical framework useful to compare different national measures and highlight their distinct characteristics. Using this framework, we further discuss the implications of various CfC measures for three primary aspects: informal caregiving, empowerment and choice of care recipients, and female employment.