Abstract:

Compares the ways in which Spain and Sweden ration home-help services for older adults. In both countries, home-help services constitute the most important public support for older adults. In Sweden, these programs were expanded in years of economic growth but recently have radically declined. Spain still strives to expand them in spite of financial problems. Both countries ration these services but in different ways. Spain provides relatively few hours of help with household tasks, primarily to poor older adults. At present, 1-2 percent of the population aged 65 or older is covered. Local government is still trying to reach more people to relieve pressure on limited institutional care. Sweden continues to cut down the service from the present rate of 9 percent of the population aged 65 or older. It is focusing on the oldest and frailest people of all classes who live alone, and the service is gradually being transformed into home health care. Institutional care has not been cut back to the same degree. Spain uses strict needs assessments and eligibility criteria to target clients, while Sweden has sharpened its needs assessments and raised fees to discourage users with lesser needs. (AS) (AgeLine Database, copyright 1999 AARP, all rights reserved)