Abstract

Italy and Spain are paradigmatic examples of the so-called "Southern European welfare model", in which the long-term care needs of dependent elderly people are mainly covered by family and intergenerational solidarities, while the institutional support (in particular through in-kind services) is structurally residual. However, over the last years, a different trajectory of institutional change seems to have taken place in the two countries: Italy characterised by an inertial re-production of its consolidated welfare system, while Spain characterised by a radical change in the wake of the approval of an important national reform about long-term care for dependent people. Despite these different institutional trajectories, our hypothesis is that the two countries still share important similarities due to the impact of the austerity policies and the functioning of a multilevel governance of long-term care policy characterised by a sort of vicious layering, which stimulates negative consequences in terms of territorial inequalities and cost-shifting dynamics (included increasing users' copayment).