SOCIO-LEGAL TRANSFORMATION OF LONG-TERM CARE: BETWEENINSTITUTIONAL CARE, COMMUNITY-BASED SERVICES AND THEPROTECTION OF USERS’ RIGHTS
DOI:
https://doi.org/10.46763/Schlagwörter:
long-term care; community-based care; deinstitutionalisation; users’ rights; quality of care; accessibility of services; integrated care; welfare state; social law; social protection.Abstract
Contemporary long-term care systems are undergoing significant
structural and normative transformations driven by demographic ageing,
changing family structures, and increasing demand for care services. In
this context, long-term care is increasingly recognized not only as a
matter of private family responsibility, but also as an important issue of
social protection and public policy. This paper analyzes the key
instruments of social-law protection in long-term care systems, focusing
on the relationship between institutional and community-based care, the
integration of health and social services, and the legal guarantees of
quality and accessibility of care. Particular attention is devoted to
deinstitutionalization processes and the growing role of communitybased services in promoting autonomy, dignity, and social inclusion of
users. The paper further examines legal and institutional mechanisms
aimed at ensuring equal access to services, protecting users’ rights, and
establishing professional and quality standards in care provision. Using
a socio-legal and analytical approach, the paper argues that sustainable
long-term care systems depend not only on financial and institutional
capacities, but also on the ability of legal systems to balance
accessibility, quality of services, protection of users’ rights, and social
solidarity. The transformation of long-term care therefore represents
one of the central challenges of contemporary social policy and social
law.
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Literaturhinweise
Anttonen, A., & Karsio, O. (2016). Eldercare service redesign in Finland:
Deinstitutionalization of long–term care. Journal of Social Service Research,
42(2), 151–166. https://doi.org/10.1080/01488376.2015.1129017
Arroyo, E. A., Prieto, E. B., Cordero, L. F., Marín, M. L., Franco, L. C. L., Gómez,
A. L., Benedetti, F., & Díaz–Veiga, P. (2023). Toward the
professionalization of caregivers: Training and skills needed for long–term
care. Inter–American Development Bank.
Bermejo–Patón, F., del Pozo–Rubio, R., Amo–Saus, M. E., & Moya–Martínez, P.
(2024). The recovery and resilience plan on the long–term care system:
Towards a deinstitutionalization? Frontiers in Public Health, 11, Article
1130132. https://doi.org/10.3389/fpubh.2023.1130132
Council of the European Union. (2017). Council Recommendation of 22 May 2017
on the European Qualifications Framework for lifelong learning and
repealing the Recommendation of the European Parliament and of the
Council of 23 April 2008 on the establishment of the European
Qualifications Framework for lifelong learning (2017/C 189/03). Official
Journal of the European Union, C 189, 15–28.
Crozier, S. E., & Atkinson, C. (2024). You're only a care worker: Exploring the
status of adult social care work through the intersection of HRM innovation
and job quality. The International Journal of Human Resource Management,
35(8), 1486–1511. https://doi.org/10.1080/09585192.2023.2300033
Directive 2005/36/EC of the European Parliament and of the Council of 7
September 2005 on the recognition of professional qualifications. Official
Journal of the European Union, L 255, 22–142.
Directive 96/71/EC of the European Parliament and of the Council of 16 December
1996 concerning the posting of workers in the framework of the provision of
services. Official Journal of the European Union, L 18, 1–6.
Dragićević, M. (2025). O potrebi za dugotrajnom negom i ulozi države u njenom
obezbeđivanju. Zbornik radova Pravnog fakulteta u Nišu, 64(104), 245–268.
Drew, J. C. (2005). Making the long–term care environment more like home: The
Eden Alternative: What families want and why. In J. E. Gaugler (Ed.),
Promoting family involvement in long–term care settings: A guide to
programs that work (pp. 71–89). Health Professions Press.
Dunér, A., Blomberg, S., & Hasson, H. (2011). Implementing a continuum of care
model for older people. International Journal of Integrated Care, 11, e136.
Eurofound. (2020). Impact of digitalisation on social services. Publications Office of
the European Union.
European Commission. (2009). Report of the Ad Hoc Expert Group on the
Transition from Institutional to Community–based Care. European
Commission.
European Commission. (2015). ESCO strategic framework: Vision, mission,
position, added value and guiding principles. European Commission.
European Commission. (2019). ESCO handbook: European Skills, Competences,
Qualifications and Occupations. Publications Office of the European Union.
European Commission. (2022). Communication from the Commission to the
European Parliament, the Council, the European Economic and Social
Committee and the Committee of the Regions on the European Care
Strategy (COM(2022) 440 final).
Floridi, L., Cowls, J., Beltrametti, M., Chatila, R., Chazerand, P., Dignum, V.,
Luetge, C., Madelin, R., Pagallo, U., Rossi, F., Schafer, B., Valcke, P., &
Vayena, E. (2018). AI4People—An ethical framework for a good AI
society: Opportunities, risks, principles, and recommendations. Minds and
Machines, 28(4), 689–707. https://doi.org/10.1007/s11023–018–9482–5
Gil, A. P. (2021). (In)decent work conditions and quality care: An issue for long–
term care policy. Ageing & Society, 41(10), 2185–2207.
Gómez–González, E., Gómez, E., Tolan, S., Martínez–Plumed, F., Pesole, A.,
Fernández–Macías, E., Hernández–Orallo, J., Conte, A., & Grubanov
Boskovic, S. (2021). The role of digital technology in health and long–term
care sectors. In Health and long–term care workforce: Demographic
challenges and the potential contribution of migration and digital technology
(pp. 87–114). Publications Office of the European Union.
Hälso– och sjukvårdslag (2017:30), SFS 2017:30, i lydelse t.o.m. SFS 2026:1312.
Hamblin, K. (2020). Technology and social care in a digital world: Challenges and
opportunities in the UK. Journal of Enabling Technologies, 14(2), 115–125.
https://doi.org/10.1108/JET–11–2019–0052
Harahan, M. F., & Stone, R. I. (2009). Defining core competencies for the
professional long–term care workforce: A status report and next steps.
Institute for the Future of Aging Services (IFAS) & American Association
of Homes and Services for the Aging (AAHSA).
International Labour Office. (2012). International Standard Classification of
Occupations: ISCO–08. Volume I: Structure, group definitions and
correspondence tables. International Labour Office.
International Labour Organization. (2018). Care work and care jobs for the future of
decent work. International Labour Office.
International Labour Organization. (2024). Migrant workers in the care economy.
International Labour Organization.
International Labour Organization. (2024). Resolution concerning decent work and
the care economy. International Labour Conference, 112th Session.
Jackson, M. N. G., & Gaugler, J. E. (2016). Family involvement in residential long–
term care. In G. Rowles & P. Teaster (Eds.), Long–term care in an aging
society (pp. 95–110). Springer.
Kellogg, K. C., Valentine, M. A., & Christin, A. (2020). Algorithms at work: The
new contested terrain of control. Academy of Management Annals, 14(1),
366–410. https://doi.org/10.5465/annals.2018.0174
Kispeter, E., & Hussein, S. (2026). Combining professionalization and
personalization in English long–term care: Analyzing stakeholder views
through a workforce lens. Frontiers in Sociology, 10, Article 1604405.
https://doi.org/10.3389/fsoc.2025.1604405
Lamb, H. R., & Bachrach, L. L. (2001). Some perspectives on deinstitutionalization.
Psychiatric Services, 52(8), 1039–1045.
https://doi.org/10.1176/appi.ps.52.8.1039
Leichsenring, K. (2004). Developing integrated health and social care services for
older persons in Europe. International Journal of Integrated Care, 4, e10.
https://doi.org/10.5334/ijic.107
Maeda, A., & Socha–Dietrich, K. (2021). Skills for the future health workforce:
Preparing health professionals for people–centred care (OECD Health
Working Papers No. 124). OECD Publishing.
https://doi.org/10.1787/68ee1d0d–en
Mansell, J., Knapp, M., Beadle–Brown, J., & Beecham, J. (2007).
Deinstitutionalisation and community living: Outcomes and costs: Report of
a European study (Vol. 2, Main report). Tizard Centre, University of Kent.
Meijerink, J., & Bondarouk, T. (2023). The duality of algorithmic management:
Toward a research agenda on HRM algorithms, autonomy and value
creation. Human Resource Management Review, 33(1), Article 100876.
https://doi.org/10.1016/j.hrmr.2021.100876
Murphy, C., Pais, I., & Gibbons, T. (2024). Care platforms: Impacts and challenges
from a trade union perspective. Friedrich–Ebert–Stiftung & European
Federation of Public Service Unions (EPSU).
Newbould, L., Samsi, K., & Wilberforce, M. (2022). Developing effective
workforce training to support the long–term care of older adults: A review
of reviews. Health & Social Care in the Community, 30(6), 2202–2217.
https://doi.org/10.1111/hsc.13840
OECD, & European Commission. (2013). A good life in old age? Monitoring and
improving quality in long–term care. OECD Publishing.
https://doi.org/10.1787/9789264194564–en
OECD. (2023). Beyond applause? Improving working conditions in long–term care.
OECD Publishing. https://doi.org/10.1787/27d33ab3–en
Pais, I., & Marcolin, A. (2024). Digital platforms in the Italian domestic care sector:
The emergence of an unprecedented corporate logic and its implications for
workers’ social protection. International Labour Review, 163(3), 397–415.
https://doi.org/10.1111/ilr.12420
Pani-Harreman, K. E., Bours, G. J. J. W., Zander, I., Kempen, G. I. J. M., & van
Duren, J. M. A. (2021). Definitions, key themes and aspects of ageing in
place: A scoping review. Ageing & Society, 41(9), 2026–2059.
https://doi.org/10.1017/S0144686X20000094
Rani, U., Pesole, A., & González Vázquez, I. (2024). Algorithmic management
practices in regular workplaces: Case studies in logistics and healthcare.
Publications Office of the European Union & International Labour
Organization.
Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29
April 2004 on the coordination of social security systems. Official Journal
of the European Union, L 166, 1–123.
Regulation (EU) 2016/679 of the European Parliament and of the Council of 27
April 2016 on the protection of natural persons with regard to the processing
of personal data and on the free movement of such data, and repealing
Directive 95/46/EC (General Data Protection Regulation). Official Journal
of the European Union, L 119, 1–88.
Regulation (EU) 2024/1689 of the European Parliament and of the Council of 13
June 2024 laying down harmonised rules on artificial intelligence (Artificial
Intelligence Act). Official Journal of the European Union, L 2024/1689.
Regulation (EU) 2025/327 of the European Parliament and of the Council on the
European Health Data Space. Official Journal of the European Union, L
2025/327.
Riva, M. A., & Cesana, G. (2013). The charity and the care: The origin and the
evolution of hospitals. European Journal of Internal Medicine, 24(1), 1–4.
https://doi.org/10.1016/j.ejim.2012.10.008
Robison, J., Shugrue, N., Porter, M., Fortinsky, R. H., & Curry, L. A. (2012).
Transition from home care to nursing home: Unmet needs in a home– and
community–based program for older adults. Journal of Aging & Social
Policy, 24(3), 251–270. https://doi.org/10.1080/08959420.2012.676315
Ruggiano, N., & Edvardsson, D. (2013). Person–centeredness in home– and
community–based long–term care: Current challenges and new directions.
Social Work in Health Care, 52(9), 846–861.
https://doi.org/10.1080/00981389.2013.827145
Seberíni, A., Tokovská, M., & Vallušová, A. (2023). Long–term integrated care for
older adults. Faculty of Economics, Matej Bel University in Banská
Bystrica.
Seifert, A., Cotten, S. R., & Xie, B. (2021). A double burden of exclusion? Digital
and social exclusion of older adults in times of COVID–19. The Journals of
Gerontology: Series B, 76(3), e99–e103.
https://doi.org/10.1093/geronb/gbaa098
Socialtjänstlag (2025:400), i lydelse t.o.m. SFS 2026:1314.
Sozialgesetzbuch (SGB) Elftes Buch (XI) – Soziale Pflegeversicherung, BGBl. I S.
1014, zuletzt geändert durch Artikel 4 des Gesetzes vom 30. Mai 2024, BGBl. I Nr.
173.
Stanić, K. (2023). Dugotrajna nega starih u Srbiji. Zbornik Matice srpske za
društvene nauke, 191, 151–180.
Verbakel, E., Glaser, K., Amzour, Y., Brandt, M., & Broese van Groenou, M.
(2023). Indicators of familialism and defamilialization in long–term care: A
theoretical overview and introduction of macro–level indicators. Journal of
European Social Policy, 33(1), 34–51.
https://doi.org/10.1177/09589287221150360
Wet langdurige zorg (Wlz), Stb. 2014, 494, laatst gewijzigd bij Stb. 2025, 123;
Wet maatschappelijke ondersteuning 2015 (Wmo 2015), Stb. 2014, 280, laatst
gewijzigd bij Stb. 2025, 274.
Wojczewski, S., Ďurišová, S., Pleschberger, S., Ernst, A., Bagheri, R., Hoffmann,
K., & Adler, V. (2026). Migrant live–in care workers in the global care
chain: Results from an online survey. Social Inclusion, 14, 1–20.
World Health Organization. (2017). Integrated care for older people: Guidelines on
community–level interventions to manage declines in intrinsic capacity.
World Health Organization.
World Health Organization. (2019). Classifying health workers: Mapping
occupations to the International Standard Classification. World Health
Organization.
World Health Organization. (2021). Framework for countries to achieve an
integrated continuum of long–term care. World Health Organization.
World Health Organization. (2022). Global strategy on human resources for health:
Workforce 2030: Report by the Director–General (A75/15, Seventy–fifth
World Health Assembly). World Health Organization.
Wosko, P., & Ruppe, G. (Eds.). (2016). Integrated care for older people living at
home: Current situation and ambition of sites participating in the SUSTAIN
project. Austrian Interdisciplinary Platform on Ageing.
Yeates, N. (2005). Global care chains: A state-of-the-art review and future directions
in care transnationalization research (Global Migration Perspectives No.
44). Global Commission on International Migration.
Zacharenko, E. (2024). Long–term care in EU policy 1999–2022: Women’s
responsibility, migrants’ work? Journal of Common Market Studies, 62(1),
38–54. https://doi.org/10.1111/jcms.13504
Zhang, X., McJoynt, T., Furst, J. W., & Myers, J. F. (2022). Establishing a patient–
centered virtual care model across the continuum of care. Journal of Primary
Care & Community Health, 13.
https://doi.org/10.1177/21501319221114326
Zorgverzekeringswet (Zvw), Stb. 2005, 358, laatst gewijzigd bij Stb. 2025, 150
