The authors draw on the work they have done for a major research centre, in order to assess both the shifts in policy towards the elderly which have been wrought by the austerity politics of the 1980s, and the likely long-term impact of such changes. The views taken of older people, the history of public policy toward the aged, the shifting responsibility between state and federal government are discussed.

This book is both an introduction to the existing literature on long term care issues, and an empirical assessment of policies (in the USA) to date. Its focus is primarily on state policies and the broad discretion of states in the implementation of health, income, and social service programmes that represent the essential basis of long term care for the elderly. It will help to provide a greater understanding of current public policies and their potential impact on the aged, thus providing a foundation for reassessing the federal role in long term care service systems.