The Swedish Experience: Diversification of Services and Containing Costs

Public services for older people are often limited to institutional care or home care, usually assistance provided by aides. In many countries these major services are supplemented – or substituted – by "minor" services such as transportation, meals-on-wheels, electronic monitoring, and day care. Sweden's taxpayer funded system provided comprehensive, but costly, care until the 1980s. To contain rapidly rising costs, Sweden--largely successfully--substituted these less intensive, "minor" services for more "heavy" ones. Home Help is rationed to support only the neediest, before ever-shorter institutional care. While everyone in need receives benefits, these are often delivered later than prior to the reforms. However, care across the continuum continues to be reasonably well targeted. Participants will learn that older people and their families appear to be well served by this broad range of services, particularly in contrast to the alternatives: Home Help, institutional care, or nothing.