Títol tesi: What Should We Care For? A Comparative Analysis of the Social Care Needs of Ageing Populations

Directors: Jeroen Spijker; Elisenda Rentería

Tutor: Jeroen Spijker

Defensa: 4 de juliol 2025, 11h.

Lloc: Sala de Graus “Carles Perelló”, Escola de Postgrau (UAB)

Abstract

From being a neglected dimension of societies, we now face what some call a ‘care crisis’, emphasising its urgency, while others describe it as a ‘care revolution’, highlighting its potential opportunities. These changes result, among other factors, from the challenges posed by population ageing and the increasing care needs that older individuals are expected to place on social institutions. This dissertation empirically studies these care needs by emphasising the relevance of testing some of our assumptions about their emergence due to the experience of chronic conditions and limitations in performing daily activities. Care needs are explored here through diverse methodological approaches that underline the complex relationship between curing and caring demands. Based on a shared definition of care needs, the thesis offers cross-country comparisons and a gender-sensitive analysis to gain a nuanced perspective on the consequences that ageing might have on social care needs and their linkage to healthcare needs, here defined through the experience of (multi)morbidity. At the same time, it stresses the importance of integrating these two dimensions. To do so, this thesis is composed of five chapters. The first chapter provides an Introduction, presenting the theoretical framework. The second chapter describes and explains unmet care needs in twelve European countries with different social care regimes. The third proposes a combined measure of healthcare needs, understood as multimorbidity, and social care needs to estimate the years of life expectancy with care needs in five Ibero-American countries. The fourth uses sequence analysis techniques to explore complex trajectories from the onset of chronic conditions and the emergence of social care needs in ten European countries. Finally, the fifth chapter introduces the Conclusions, summarising the main findings and their implications in the analysis of these needs. Results from this diverse analysis emphasise social factors differences in the occurrence of healthcare needs, understood as having chronic conditions, and social care needs, based on experiencing limitations for moving or performing Basic Activities of Daily Living, that are principally related, but not exclusively, to countries’ specific characteristics, gender, age and socioeconomic status. Instead of framing the care needs of older individuals as a negative consequence of ageing, it is stated that having a better understanding of these healthcare and social care needs is an opportunity to reimagine care provision more democratically.

 Keywords: Social care needs, Multimorbidity, Cross-country comparisons, Europe, Latin America

Tribunal:

Presidenta: Athina Vlachantoni (Departament de Gerontologia, University of Southampton, Regne Unit)

Secretari: Jordi Gumà (Centre d’Estudis Demogràfics-CED)

Vocal: Madelín Gómez (Dep. Ciències Polítiques i Socials, Universitat Pompeu Fabra-UPF)