European Journal of Ageing

, Volume 9, Issue 2, pp 101–109 | Cite as

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

  • Tine RostgaardEmail author
  • Marta Szebehely
Original Investigation


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 de-familialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.


Home care Sweden Denmark Informalisation Marketisation De-familialisation 



We would like to thank Minna Zechner, Gun-Britt Trydegård, Lina van Aerschot and two anonymous referees for valuable comments on an early version of this article.


  1. Anttonen A (1998) The welfare state and social citizenship. In: Kauppinen K, Gordon T (eds) Unresolved dilemmas. Women, work and family in the United States, Europe and the Former Soviet Union. Ashgate, Aldershot, pp 9–32Google Scholar
  2. Anttonen A, Sipilä J (1996) European social care services: is it possible to identify models? J Eur Soc Policy 6(2):87–100CrossRefGoogle Scholar
  3. Anttonen A, Baldock J, Sipilä J (eds) (2003) The young, the old and the state: social care systems in five industrial nations. Edward Elgar, CheltenhamGoogle Scholar
  4. Daatland SO, Lowenstein A (2005) Intergenerational solidarity and the family-welfare balance. Eur J Ageing 2:174–182CrossRefGoogle Scholar
  5. Egger Nielsen J, Goul Andersen J (2006) Hjemmehjælp. Mellem myter og virkelighed [Home care. Between myths and realities]. Syddansk Universitetsforlag, OdenseGoogle Scholar
  6. Esping-Andersen G, Korpi W (1987) From poor relief to institutional welfare states. In: Erikson R, Hansen EJ, Ringen S, Uusitalo H (eds) The Scandinavian model. M.E. Sharpe, Armonk, pp 39–74Google Scholar
  7. Eurobarometer (2007) Health and long-term care in the European Union. Special Eurobarometer 283. European Commission. Accessed 7 Feb 2011
  8. Eurofound (2005) European working conditions observatory. Accessed 7 Feb 2011
  9. Hernes H (1987) Welfare state and woman power. Essays in state feminism. Norwegian University Press, OsloGoogle Scholar
  10. Huber M, Rodrigues R, Hoffmann F, Gasior K, Marin B (2009) Facts and figures on long-term care. Europe and North America. European Centre, ViennaGoogle Scholar
  11. Johansson L, Sundström G, Hassing L (2003) State provision down, offspring’s up: the reverse substitution of old-age care in Sweden. Ageing Soc 23:269–280CrossRefGoogle Scholar
  12. Kautto M, Heikkilä M, Hvinden B, Marklund S, Ploug N (eds) (1999) Nordic social policy: changing welfare states. Routledge, LondonGoogle Scholar
  13. Kröger T (2005) Interplay between formal and informal care for older people: the state of the Nordic research. In: Szebehely M (ed) Äldreomsorgsforskning i Norden. En kunskapsöversikt [Nordic eldercare research. An overview] TemaNord 2005, vol 508. Nordic Council of Ministers, Copenhagen, pp 243–280Google Scholar
  14. Leitner S, Lessenich S (2007) (In)dependence as dependent variable: conceptualizing and measuring ‘de-familization’. In: Clasen J, Siegel N (eds) Investigating welfare state change: the ‘dependent variable problem’ in comparative analysis. Edward Elgar, Cheltenham, pp 244–260Google Scholar
  15. Lewis J (2002) Gender and welfare state change. Eur Soc 4(4):331–357CrossRefGoogle Scholar
  16. Lister R (1995) Dilemmas in engendering citizenship. Econ Soc 24(1):1–40CrossRefGoogle Scholar
  17. Meagher G, Szebehely M (2010) Private financing of elder care in Sweden. Arguments for and against. Working Paper 1/2010. Institute for Futures Studies, StockholmGoogle Scholar
  18. NBHW (2009) Äldre—vård och omsorg den 30 juni 2008 [Care and services to older persons 30 June 2008]. National Board of Health and Welfare (Socialstyrelsen), StockholmGoogle Scholar
  19. NBHW (2010) Vad tycker de äldre om äldreomsorgen? En rikstäckande undersökning av äldres uppfattning om kvaliteten i hemtjänst och äldreboenden 2010 [National study of users’ perception of quality in home care and residential care 2010]. National Board of Health and Welfare (Socialstyrelsen), StockholmGoogle Scholar
  20. Nososco (2009) Social protection in the Nordic countries. Scope, expenditure and financing 2007/2008. Nordic Social-statistical Committee, CopenhagenGoogle Scholar
  21. Ogg J, Renaut S (2006) The support of parents in old age by those born during 1945–1954: a European perspective. Ageing Soc 26:723–743CrossRefGoogle Scholar
  22. Rauch D (2007) Is there really a Scandinavian social service model? Acta Sociol 50(3):249–269CrossRefGoogle Scholar
  23. Rostgaard T (2004) With due care: social care for the young and the old across Europe. PhD Thesis, The Danish National Institute of Social Research, CopenhagenGoogle Scholar
  24. Rostgaard T, Fridberg T (1998) Caring for children and older people—a comparison of European policies and practices. The Danish National Institute of Social Research, CopenhagenGoogle Scholar
  25. Sipilä J (ed) (1997) Social care services: the key to the Scandinavian welfare model. Avebury, AldershotGoogle Scholar
  26. Statistics Denmark (2010) Varig hjemmehjælp 2009. Nyt fra Danmarks Statistik [Home care services 2009. News from Statistics Denmark]. No 187Google Scholar
  27. Statistics Denmark (2011) Varig hjemmehjælp 2010. Nyt fra Danmarks Statistik [Home care services 2009. News from Statistics Denmark]. No 177Google Scholar
  28. Statistics Sweden (2011) Skattereduktioner år 2000–2009 [Tax deductions. Statistical database on tax statistics]. Accessed 9 Mar 2011
  29. Sundström G, Johansson L, Hassing L (2002) The shifting balance of long-term care in Sweden. Gerontologist 42:350–355CrossRefGoogle Scholar
  30. Szebehely M (2005) Care as employment and welfare provision—child care and elder care in Sweden at the dawn of the 21st century. In: Dahl HM, Rask Eriksen T (eds) Dilemmas of care in the Nordic welfare state. Ashgate, Aldershot, pp 80–97Google Scholar
  31. Szebehely M, Trydegård G-B (2007) Omsorgstjänster för äldre och funktionshindrade: skilda villkor, skilda trender? [Services for older and disabled persons: different trends, different conditions?]. Socialvetenskaplig Tidskrift 14(2–3):197–219Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Aalborg UniversityAalborg ØDenmark
  2. 2.Department of Social WorkStockholm UniversityStockholmSweden

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