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

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.