Scientific and legal concepts of care dependency: Role for understanding, emotional responding, and acting in the field of elder care

In this chapter, we analyze scientific and legal concepts of care dependency and explore their roles for understanding, emotional responding, and acting of various participants in the field of elder care. First, two comprehensive concepts from the nursing sciences are contrasted. Then we compare a scientific and two legal concepts (restrictive vs. inclusive) of care dependency from the German long-term care (LTC) system, the last of which regulate older persons´ access to LTC benefits. Here, we consider their different implications for the risk of unmet psychological, social, and temporary care needs. Next, we examine the theoretical and methodological roles of different care dependency concepts for assessment as well as the analysis of prevalence, antecedents, consequences, and the management of care dependency. Following this, we explore possible functions of care dependency concepts as cognitive mediators of various agents’ activities related to elder care, which opens new topics for further research. Among these, we include the ascription of care dependency by various actors, older people´s self-presentation, and family carers´ presentation and LTC administrators´ evaluation of an older person´s care dependency. Further issues addressed are the education of professional care workers and professionals´ provision of elder care. Here, special attention is devoted to the implications of a shift from a restrictive to a more inclusive legal concept of care dependency as recently happened in Germany. Finally, we discuss the implications of inclusive legal concepts of care dependency for the improvement of elder care quality