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