Trends in care and services for elderly individuals in Denmark and Sweden.

Both Denmark and Sweden have achieved a reduction in institutionalization of elderly individuals; 23 percent nursing home care in Denmark from 1980-89 and 34 percent overall institutionalization in Sweden from 1970-1985. This was accomplished by increasing home care and housing with services and adaptations. Further increases in growth of the elderly population combined with modest economic expansion will be the forces responsible for finding additional alternatives to costly institutional care. Community-based services and care have not been demonstrated at this time to be less costly than institutional care. An illustration of an innovative model of nursing home care in Denmark is described. The medical model of care was abandoned in favor of a self-care model for the purpose of fostering independent living and decision-making as long as possible. In Sweden, a reduction in demand for beds in a long-term care hospital has been achieved through a tightly coordinated system of care and services among the various health and social service professionals.