Care according to age: A case of ageism or a conflict on needs?

Abstract

Despite a strong emphasis that individual support services should be provided according to needs, the Swedish welfare system often use age to organize support. A change in the Social Service Act in 2018 allows municipalities to provide home care for people above a decided age without individual any assessment of needs. Political parties and pensioners’ organizations’ have proposed for the introduction of a nursing home guarantee that assure that people over 85, regardless of needs, have the statutory right to move to a nursing home. Within the field of critical gerontology, age-based categorizations are widely acknowledged as forms of ageism and a nursing home guarantee could be criticized for communicating that people above the age of 85 are a dependent category that belong in nursing homes. But what are older people’s own views on such age-based arrangements? Based on eleven peer-group interviews with 27 older people, the aim of this paper is to investigate reasoning on age-based eligibility. Guided by Bradshaw’s typology on needs, the analysis revealed a controversy concerning both the meaning of needs and the meaning of age. A conclusion is that while professionals and gerontologist may dismiss a nursing home guarantee as a case of ageism, older people perceived this as a means to strengthen their rights. A nursing home guarantee was portrayed as a way of tackling ageism in a system that fails to meet the needs of older people by denying them access to care.