Research Coordinator, The National Board of Health and Welfare, Stockholm, Sweden.
J Aging Soc Policy. 2011 Oct;23(4):335-53. doi: 10.1080/08959420.2011.605630.
In Sweden, care of elderly people is a public responsibility. There are comprehensive public policies and programs providing health care, social services, pensions, and other forms of social insurance. Even so, families are still the major providers of care for older people. In the 1990s, the family was "rediscovered" regarding eldercare in Sweden. New policies and legislative changes were promoted to support family caregivers. The development of services and support for caregivers at the municipal level has been stimulated through the use of national grants. As a result, family caregivers have received more recognition and are now more visible. However, the "Swedish model" of publicly financed services and universal care has difficulty addressing caregivers. Reductions in institutional care and cutbacks in public services have had negative repercussions for caregivers and may explain why research shows that family caregiving is expanding. At the same time, a growing "caregivers movement" is lobbying local and national governments to provide more easily accessible, flexible, and tailored support. In 2009, the Swedish Parliament passed a new law that states: "Municipalities are obliged to offer support to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities." The question is whether the new legislation represents a paradigm shift from a welfare system focused on the individual to a more family-oriented system. If so, what are the driving forces, motives, and consequences of this development for the different stakeholders? This will be the starting point for a policy analysis of current developments in family caregiving of elderly people in Sweden.
在瑞典，老年人护理是公共责任。有全面的公共政策和计划提供医疗保健、社会服务、养老金和其他形式的社会保险。即便如此，家庭仍然是老年人护理的主要提供者。在 20 世纪 90 年代，瑞典重新发现了家庭在老年人护理方面的作用。新的政策和立法改革被用来支持家庭照顾者。通过利用国家赠款，在市级层面上刺激了照顾者服务和支持的发展。因此，家庭照顾者得到了更多的认可，现在更加引人注目。然而，公共资金服务和普遍护理的“瑞典模式”难以解决照顾者的问题。机构护理的减少和公共服务的削减对照顾者产生了负面影响，这可能解释了为什么研究表明家庭护理正在扩大。与此同时，一个不断壮大的“照顾者运动”正在游说地方和国家政府提供更易获得、更灵活和更量身定制的支持。2009 年，瑞典议会通过了一项新法律，规定：“市政府有义务为照顾慢性病患者、老年人或功能残疾者的人提供支持。”问题是，新立法是否代表着从以个人为中心的福利制度向更加以家庭为导向的制度的范式转变。如果是这样，对于不同的利益相关者来说，这种发展的驱动力、动机和后果是什么？这将是对瑞典老年人家庭护理当前发展进行政策分析的起点。
