After attending the first session of the UN’s Open-Ended Working Group on ageing I wanted to take a closer look Sweden. The reason why is not just because it’s where I’m from, but also because I have experience working with what we in Sweden call Home Help. This program, Home Help, is a part of the public health sector. It makes it possible for older people to keep living in their own homes and receive the individual help they might need-, such as cleaning, cooking, shopping, or to accompany the older person to the dentist or doctor. As I worked in this job, I learned how older people live Sweden.
Sweden has a fairly small population of about 9.3 million people. Around 19 percent are aged 65 or older; few other countries have such a large proportion of elders in the population. Sweden has one of the world’s longest life expectancies and one of the lowest birth rates. As the 1940’s baby boomers age, these numbers are expected to grow faster and in greater numbers than ever before. Up until now, Sweden has been able to manage and provide well for its older citizens. For instance, in 1982 the Social Services Act stated that all individuals have the right to public services at all stages of life. Everyone who needed help with his or her daily life had the right to claim assistance if they were unable to meet their needs in any other way. The Swedish welfare policy provides an “old age pension.” Everyone who has reached the age of 65 years, regardless of income, gets a certain amount of a state allowance. Now, the current demographic developments are challenging this policy.
Mats Thorslund, Professor in Social Gerontology, at Karolinska Institutet, a medical university in Stockholm, has researched the trends in the living conditions and health of the older population. Thorslund’s studies outline some of the biggest problems Sweden faces as the number of older persons increases. He argues that the government is failing to look at the numbers in a realistic way. As the aged increase in the population, the government does not have sufficient programs available for those who need care. People with dementia are always a first priority. But if the existing facilities are filled, there will be no spots left for the rest. This implies that the Swedish communes will need to hire more people to work in this field. The government needs to set priorities A rarely mentioned problem is the low wages in the health care field as well as the need for workers who have sufficient at the salary in this field is low and the job requires physical strength. Women dominate this field and often end the career with a worn out body.
Thorslund also found that there are visible gender and class differences. Social status and class correlate with health and functional capacity. This is more visible among men than women. When facing dependency, the majority of old men receive care from spouses, while old women rely on relatives or public care. Men have higher odds of receiving care. A 2002 study showed that elders’ health has worsened. This information contradicts data from other parts of the world. How can this can be possible? What does this indicate? Could it have something to do with the fact that a lot of the Swedish older people live by themselves?
During my job with Home Help, I discovered that older people who lived by themselves often felt lonely; my visit was the highlight of their day. Some of them had families who would come and visit, some of them did not. I always felt sad that I was on a tight schedule and could only offer limited time to them. Because I worked in the countryside, I noticed that the resident felt more isolated; there was a lot of space in between the houses and most of them were very limited as to how much they could move outside their own homes. Although Sweden has social programs and events for older persons, I noticed that the government cuts the older persons’ programs first; this is where it hits hard.
Thorslund and his research team have finished a number of research studies but the results have not been used in the best way possible. Need no longer determines policy; rather it’s the economy. Some theorists suggest that the needs of the increasing number of very old Swedes will change the government’s model of the welfare state. No longer, they say, will Sweden provide its older citizens with care and support on equal terms. In 1970 Sweden reached its highest level of service and care for the old. If Swedes want to stay in this position, it will have to examine where the national resources are going—to the wealthiest? To the best connected to the government? Banks? Industrial profits? A Monarchy? Other? Older citizens have been aging for more than 60 years and more will come. Swedish citizens will have to decide where they want their taxes to go. This challenge faces not only for Sweden, but many nations.
Sanna Klemetti
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