In Europe, on average, three times as many adult children occasionally help their parents with the housekeeping than do provide regular physical care. This is not surprising, considering the great differences between these two types of support. Care follows needs, whereas help tends to be given sporadically when one has the opportunity. In the familial welfare states in Southern Europe, where little professional support is available, provision of care by children is more likely—whereas parents in the north are more likely to receive help in the household or in dealing with the authorities. Logistic multi-level models enable these differences to be traced back to the availability of social and health services in the individual countries. There is a ‘crowding in’ of the help children give their parents, but a ‘crowding out’ of physical care. Overall, the results based on the Survey of Health, Ageing and Retirement data thus support the specialization hypothesis: professional providers take over the medically demanding and regular physical care, whereas the family is more likely to provide the less demanding, spontaneous help. Everyone does what they do best. The overall care of older people thus tends to be assured both quantitatively and qualitatively by well-developed service systems.

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