| 2. |
- Trydegård, Gun-Britt, 1937-, et al.
(författare)
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One uniform welfare state or a multitude of welfare municipalities? The evolution of local variation in Swedish elder care
- 2010
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Ingår i: Social Policy & Administration. - Birmingham, UK : Wiley-Blackwell. - 0144-5596 .- 1467-9515. ; 44:4, s. 495-511
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Tidskriftsartikel (refereegranskat)abstract
- The Nordic welfare states, including Sweden, have an inbuilt dilemma between two mainprinciples: universalism and local autonomy. The concept of ‘welfare municipalities’ has been usedto characterize the social policy construction of independent local authorities implementing nationalwelfare policies. The aim of the article is to study the evolution of the balance between universal,centralized versus local, decentralized principles in Swedish welfare services, using elder care as acase. The article follows up previous studies on the extensive diversity and the local path dependencyin the distribution of elder-care services in Sweden. A predominant impression from the presentexploration is that the pattern has changed in many aspects during the first decade of the newmillennium, and in a complex way. The coverage of home help and residential care has become lessgenerous, a sign of weaker universalism. On the other hand, the decentralization tendencies havedecreased, the earlier reported geographical disparity appears to have been reduced and the municipalitiesare increasingly adjusting to the national average. Also, the earlier strong local pathdependency has faded out and therefore the concepts ‘welfare municipality’ and ‘local social policy’appear to be less accurate than heretofore when describing the Swedish model of elder care.
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| 3. |
- Trydegård, Gun-Britt, 1937-
(författare)
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Tradition, change and variation : past and present trends in public old-age care
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this dissertation is to describe and analyse how public old-age care in Sweden has developed and changed during the last century. The study applies a provider perspective on how care has been planned and professionally carried out. A broader social policy perspective, studying old-age care at central/national as well as local/municipal level, is also developed. A special focus is directed at the large local variation in care and services for the elderly. The empirical base is comprised of official documents and other public sources, survey data from interviews with elderly recipients of public old-age care, and official statistics on publicly financed and controlled old-age care and services.Study I addresses the development of old-age care in Sweden during the twentieth century by studying an important occupation in this field – the supervisors and their professional roles, tasks and working conditions. Throughout, the roles of supervisors have followed the prevailing official policy on the proper way to provide care for elderly people in Sweden; from poor relief at the beginning of the 1900s, via a generous level of services in the 1960s and 1970s, to today’s restricted and economy-controlled mode of operation.Study II describes and compares two main forms of public old-age care in Sweden today, home help services and institutional care. The care-load found in home-based care was comparable to and sometimes even larger than in service-homes and other institutions, indicating that large care needs among elderly people in Sweden today can be met in their homes as well as in institutional settings.Studies III and IV analyse the local variation in public old-age care in Sweden. During the last decades there has been an overall decline in home help services. The coverage of home help for elderly people shows large differences between municipalities throughout this period, and the relative variation has increased. The local disparity seems to depend more on historical factors, e.g., previous coverage rates, than on the present municipal situation in levels of need or local economy and politics.In an introductory part the four papers are linked together by an outline of the demographic situation and the social policy model for old-age care in Sweden. Trends that have been apparent over time, e.g. professionalisation and market orientation, are traced and discussed. Conflicts between prevailing ideologies are analysed, in regards to for instance home-based and institution-based care, social and medical culture, and local and central levels of decision-making. ’Welfare municipality’, ‘path dependency’, and ‘decentralisation’ are suggested as a conceptual framework for describing the large and increasing local variations in old-age care. Finally, implications of the four studies with regard to old-age care policy and further research are discussed.
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