Receipt of Formal and Informal Help with Specific Care Tasks among Older People Living in their Own Home. National Trends over Two Decades

Abstract

Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care-receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care-receipt were examined in relation to gender, living alone, having children and socio-economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care-receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care-receipt, associated with a greater likelihood of formal care-receipt and a lower likelihood of informal care-receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.

Long-Term Care Use During the Last 2 Years of Life in Sweden: Implications for Policy to Address Increased Population Aging

“…34 Yet, when relationships last into advanced old age, the capacity of caring for a partner toward the end of life, when care needs often are extensive, may be limited among very old couples. Against the background of recent developments in the Swedish LTC system, it may be expected that support from family members outside the household will gain importance, 25,35 as well as services paid out of pocket, indicating a narrower definition of public responsibility. 25,33,36…”

Beyond the definition of formal care: Informal care arrangements among older swedes who are not family

“…About 37% of older Swedes provide informal help to family, friends or neighbours (Hank & Stuck, ) and about 52% identify themselves as informal helpers for a person outside their own homes (Jegermalm & Jeppsson Grassman, ). In an international comparison, spending on elderly care in Sweden is fairly high; however, as provisions of formal care have not kept pace with the ageing population (Rostgaard & Szebehely, ; Szebehely & Trydegård, ), many older people rely on informal care (Dahlberg, Berndt, Lennartsson, & Schön, ). Altogether, Sweden is a suitable setting to explore care practices among older people.…”

Type of Care and Living Situation Are Associated with Nutritional Care but Not Nutritional Status of Older Persons Receiving Home Care

“…Providing adequate nutritional care, i.e., support with shopping, preparing meals, eating and drinking, for this frail group seems to be crucial, but may be required in varying degrees, depending on the overall need of care, and may be provided by different people and services. It has been shown in a study on older adults living at home and being in need of care in Sweden that those who did not live alone received more nutritional care from their informal caregivers compared to those who lived alone [6]. Another study also from Sweden similarly reported that informal caregivers are the primary source of providing nutritional care and support in older adults living in private households [21].…”

“…Most older adults are willing to spend their last years of life in their own household [2]. Previous studies in several European countries have shown that more than half of the older adults receiving care at home are living alone [3][4][5][6].…”