Care for dependent elderly people : dealing with health and financing issues.

Summary In the context of a rapidly aging population, this doctoral dissertation explores the relationship between health and long-term care arrangements and addresses the issue of the financing of long-term care.Meeting the needs of dependent elderly is an important objective of public policy. Chapter 1 estimates the effects of both informal (i.e. family) care and formal (i.e. professional) home care on the mental health of French dependent elderly. The results highlight that informal care decreases the risk of depression and that formal care can improve general mental health.Recent studies acknowledge that providing informal care has adverse health effects and emphasize the importance of supporting caregivers. Chapter 2 examines the effect of social support on caregivers' health. It shows that formal care and informal support limit the negative consequences of caregiving on mental health.Finally, given the increasing financial and fiscal pressure on public systems, Chapter 3 investigates to what extent Europeans elderly are able to pay for their periods of long-term care needs on the basis of their income, financial assets and home equity. It also studies the role of reverse mortgages. The simulations stress that only a small proportion of individuals would be able to finance totally their long-term care expenses and that housing assets may play an important role in long-term care financing.