Policy reforms targeting care for older adults in Lithuania

This thesis project investigates policy reforms surrounding the care of older people in post-socialist Lithuania. It is argued that institutional arrangements inherited from the socialist era were shaped by indigenous practices of pre-industrialized Lithuania, as well as polices of the Communist regime. The moral economy of aging-in-place in pre-WWII Lithuania centered on multi-generational rural homesteads where care of the aged was assumed to be the responsibility of children and the closest kin. With rapid urbanization and industrialization of Lithuania during Soviet times, the rural population began to rapidly decline. When children living in the cities were becoming caretakers of aging parents, new patterns of rural-urban migration of older adults were established, which, reproduced multi-generational households--but this time in urban areas. Well-established patterns of urban-rural migration of older adults characterized a post-independence period in Lithuania due to long-term demographic factors as well as radical socio-economic reform and cultural changes. The severe economic recession of the early 1990s significantly reduced the state's expenditures on social services, while large-scale emigration to European Union countries destabilized informal family networks of support. Thus, a growing number of older people - especially in rural areas - found themselves pauperized, which occurred simultaneously with a decline in social services. By the mid 1990s, growing elder-care needs had generated three societal responses, which will be analyzed in detail in this thesis: (a) reforms and expansion of state care provisions for older adults; (b) rise of religious charities devoted to the care of older adults; and (c) initiatives to develop community- based social services. This thesis will discuss the implications of the evolving plural social care model for addressing growing elderly care needs in Lithuania.