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[Social services and the pressure to modernize: new needs and developmental trends in care of the elderly].

Demographic and sociostructural changes put pressure on care services for the elderly within the German welfare system: There is a need for facilities and new concepts. This also requires more and flexible domestic services, which are poorly developed in the German social system. Because the German range of care provider types is easy to navigate, there is increased demand for consumer information and recommendations. Considering the domains of care services, which have been widely distributed to the powerful non-profit welfare organizations, the status quo vs. new flexible service will challenge consumers confidence and choice, especially since todays elderly are more active and have more expendable income. The recently instituted "long-term care insurance" encourages, for the first time, competition between nonprofit organizations and commercial providers. Nevertheless, a clearly perceptible "polarization of age" draws attention to persisting challenges to social policy. Therefore, the increasing competition among types of care providers urges for a truly independent quality control, as well as an effective "welfare mix".

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The development of health and social services for the elderly in Iceland: an overview.

In the present paper, we provide a general overview of the changing position of the aged population in Iceland. After a long history of subsistence, Icelandic society has evolved only recently from pre-industrial conditions compared with other Western developed nations. The 1000-year preindustrial record is in large part one of a struggle for survival in which formal and informal measures to support the frail and disabled were often overwhelmed by disease and famine; this history is outlined to provide a baseline for recent changes. Both the speed and propinquity of Iceland's transition from these conditions have left a unique stamp on the present-day society: development has driven a quick elaboration of occupational roles and other social status shifts, vast health status improvements, and great population and urban growth. Public and personal health services have grown in scope and adequacy in comparatively recent decades, contributing to the now unsurpassed health status of the general population. The effect of these trends on the condition of elderly is described. As the birth rate in Iceland has dropped in recent decades, the proportion and number of Icelanders in the older and especially the oldest age-strata has been steadily rising. The current and planned organization of health and social services is reviewed, as Iceland faces new tasks of caring for elderly.

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