Swedish model of elderly care: living at home for as long as possible

Once a day, nursing assistant Hadi Hosseini knocks on the door of Göte Lindström's little red house. The island of Harö in the Swedish municipality of Värmdö has been his home since he was a child. Even today, at 96 years old.

Hosseini helps with the dishes, takes out the trash and cleans the bathroom. Because such everyday activities are now difficult for Lindström. He is happy about the help that the municipality is organizing for him at home. “You can’t have too high expectations when you get old,” he says. "But I'm glad that I can live here for so long. I hope that I can stay here until the end."

Care at home as a basic principle

Ensuring that older people live in their own four walls for as long as possible is a basic principle of Swedish geriatric care. A place in a nursing home is usually only an option when care at home is no longer sufficient.

To make this possible, there is an extensive home care service. Depending on your needs, nursing staff can provide support with personal hygiene, dressing or showering, household chores or meals.

How much help someone gets is checked individually, explains Therese Malm, who is responsible for elderly care at the Värmdö municipality's social and nursing office. “The goal is for people to be able to stay at home for as long as possible,” she says.

Your own contribution is limited

How much those in need of care have to pay for support depends on their personal situation. However, there is an upper limit for the financial contribution for home care across the country. It is a maximum of 2,660 crowns per month, the equivalent of just under 240 euros. Some pay less.

Income and housing costs are taken into account in the calculation. In addition, those in need of care must be left with a set amount for their normal living expenses. “Home care should be accessible to everyone, regardless of what pension they receive and what their income is,” says Malm.

Different financing than in Germany

Those in need of care do not bear most of the actual costs themselves. Care for the elderly in Sweden, whether in a nursing home or at home, is largely financed by taxpayers' money, explains Anne Marie Boström, lecturer in nursing science at the Karolinska Institute in Stockholm.

This is one of the main differences to the German system. Nursing care insurance is responsible there and is financed primarily through contributions from insured persons and employers.

However, it is only a partial insurance: the benefits are capped, and those in need of care have to bear any additional costs themselves. You can also use your own assets for this purpose.

Home care is cheaper

In Sweden, how often the nursing service comes by depends on individual needs. This can also be several times a day. If more and more missions are necessary, we will check together with those affected whether care at home is still sufficient or whether a place in a nursing home would make more sense.

For local authorities, home care is significantly cheaper than a place in a nursing home. And most people in need of care are satisfied with it.

According to Boström, in the annual surveys conducted by the Swedish Social Security Agency, between 80 and 90 percent of participants generally say positive things about their home care service. This applies to the quality of care and other services such as cleaning as well as to the treatment of those in need of care.

Personnel becomes a problem

But the Swedish model also faces challenges. People are living longer, which means the need for care is also growing. In many places it is already difficult to find enough employees.

“The biggest problem is meeting the staffing needs in geriatric care,” says nursing scientist Boström. There are not many young people left who can imagine a future in geriatric care.

Caring in the archipelago requires good timing

Hadi Hosseini consciously chose this profession. The now 26-year-old came to Sweden eleven years ago as a refugee from Afghanistan. He initially worked in the catering industry, then trained as a nursing assistant. He has been working in geriatric care for five years. “It means a lot to me that I can bring joy to people and help them with the things they can no longer do themselves,” he says.

However, everyday working life can also be stressful, says Hosseini. For example, if individual people in need of care need more time than is planned for the respective visit. This is particularly difficult when working in the archipelago.

Unlike on the mainland, Hosseini does not travel here by car, but relies on a taxi boat rented by the municipality. "Then we have to move on quickly to the next one. We have booked the boat at certain times and have to make it there in the set time."

With Göte Lindström on Harö there is almost always time for a little chat. The 96-year-old is happy that someone comes by every day. And as long as he can, he wants to stay in his little red house. "This is my home, it has been my entire life."