The changing balance of government and family in care for the elderly in Sweden and other European countries

Patterns of care for the elderly have changed dramatically in Sweden over the post-war years, and new trends have emerged in the last decade. Relatively fewer elderly are institutionalised or use public Home Help and more are helped by family members. The family structure of the elderly in Sweden is more favourable today than before for providing help: more elders are married (or cohabit) and stay married longer and more of them have children and other kin than previously. Although old parents and their offspring very seldom live together, they often do not live far apart. Social services increasingly target elders who are short on kin, very frail and live alone, a pattern that is common in European countries. Both carers and cared-for elderly persons want shared responsibility, that state and family together provide for frail elders. Paradoxically, more elders are cared for longer and more by their families, but eventually also a larger proportion of elders than before use public services; in particular, more elderly persons now use institutional care for some period before the end of their life than previously. This paper draws on evidence across 50 years of shifting patterns in Swedish old age care and makes comparisons with living arrangements and patterns of care in several western European countries.