The special issue on Home Care in Europe (edited by Virpi Timonen, Tine Rostgaard and Caroline Glendinning).
Transformation by stealth: the retargeting of home care services in Finland
Article first published online: 9 DEC 2011
© 2011 Blackwell Publishing Ltd
Health & Social Care in the Community
Special Issue: Reforming Home Care in Ageing Societies
Volume 20, Issue 3, pages 319–327, May 2012
How to Cite
Kröger, T. and Leinonen, A. (2012), Transformation by stealth: the retargeting of home care services in Finland. Health & Social Care in the Community, 20: 319–327. doi: 10.1111/j.1365-2524.2011.01047.x
- Issue published online: 19 APR 2012
- Article first published online: 9 DEC 2011
- Accepted for publication 4 October 2011
- home care;
- informal care;
- Nordic welfare model;
This paper analyses the trends and changes that home care services for older people have undergone during the last two decades in Finland. The data used come from national social care statistics, covering the time period from 1990–2010. The results show that, in contrast to many other European nations that have expanded their home care provisions, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions and often need to rely on family members. In most localities, public service provision is focused on personal care, and no longer covers household tasks. This major change of the character of the service is connected to three other recent trends that structure current provisions: the amalgamation of home-based social and healthcare services, the marketisation and emerging privatisation of care and the integration of informal family care into the formal care system. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth.