Changing policies, changing patterns of care: Danish and Swedish home care at the crossroads

Abstract

Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67-87 in need of practical help), the article investigates the consequences of the two policy approaches for older people of different needs and socio-economic backgrounds and evaluates how the development corresponds with ideals of universalism in the Nordic welfare model. Our findings show that in both countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers. Not only does this leave some older people more at risk, it also questions the degree of defamilialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.

Informal eldercare and care for disabled children in the Nordic countries: prevalence and relation to employment

“…A recent analysis of sources of care among older people in Denmark and Sweden points in the same direction: significantly more older people in need of care in Sweden report that they receive help from children and other family members or friends (help from spouses not included) (Rostgaard & Szebehely, 2012). However, as the Danish services are less intensive, it may be the case that informal care is more intensive in Denmark.…”

The Fragmented Welfare State: Explaining Local Variations in Services for Older People

“…Most older adults not living alone live together with a partner; intergenerational cohabitation is atypical in Denmark, and family members (daughters, sons or other relatives) rarely provide personal care to frail older adults in Denmark (cf. Rauch, 2008;Rostgaard et al, 2011;Rostgaard and Szebehely, 2012). That is, the informal care sector is small relative to other countries with less developed formal care sectors.…”

Quasi-markets Targets and the Evaluation of Nursing-home Funding in the Valencian Region

“…Furthermore, quasi-markets have been considered by governments as an alternative of public services financing, hoping to reduce public expenditure and prices among nursing-homes, and to achieve better quality and equity (Kähkönen, 2004;Hansen, 2010). Until now, many experts have focused their studies on these topics but without finding clear effects (Forder and Allan, 2011;Forder and Allan, 2014;Rostgaard and Szebehely, 2012;Meagher and Szebehely, 2013). Spain is also introducing some elements of competition in social services for elderly people.…”