ABSTRACT
The reason for this choice is that in the area of LTC, many different strands of arguments are used for alterations. Ongoing demographic changes, economic constraints, involvement of civil society and use of market mechanism are all elements in the changes within LTC (Pavolini and Ranci, 2008). There was a real growth in expenditures on LTC from 2005 to 2011 in most countries within the OECD area, with the exception of Hungary and Finland (OECD, 2013c). There is also an expected increase in the years to come due to the demographic change of there being more elderly and more people who are very old (de la Maisonneuve and Martins, 2014), although healthy ageing might reduce the pressure. How to measure and understand change, especially if the focus is on the quality of care, can be very difficult. It is also an area where informal and formal care works along the same lines and where the boundaries between civil society, state and market are under constant change. There are also challenges to understanding the balance between the actors.
