Long-term care in Sweden : trends, actors, and consequences

Sweden constitutes a traditionally well-developed system of long-term care, based on tax-funded, mainly publicly provided services. This system has changed significantly in recent decades. There has been some retrenchment in eldercare evident in falling coverage and stronger targeting of people with higher levels of need. This development has led to the informalization of care for some groups of older people. In disability care, there has been a considerable expansion of services, perhaps most notably in the introduction of a personal assistance scheme for people with severe disabilities. These divergent trends in services for older people and people with disabilities have coincided with a convergent development across both care fields: the marketization of services and the emergence of large, corporate, for-profit providers. This chapter explains how and why these changes have happened, and their consequences for service users and for the possible future of social care in Sweden. In addition to the dynamic interaction of state-steering and municipal response that are typically important in explaining change in patterns of social service in countries with multilevel government, invasive displacement and layering are identified as processes transforming the institutions that directly and indirectly organize care service provision.24 page(s