Care for the elderly: welfare system, professionalisation and the question of inequality

Abstract

Since the 1960s, the health system has seen the professionalisation of a new occupation, carer of the elderly. The form and result of this process differs between countries according to their welfare systems. In this paper, the differences will be analysed in a comparison between two countries, Germany and Sweden, the representatives of two prototypical welfare systems. Sweden is renowned for its state‐oriented universal welfare system, whereas Germany is considered to be an example of a conservative, family‐oriented system. The process of professionalisation and its consequences for the carer and the care receivers will be looked at from the perspective of gender and social inequality. On a theoretical basis, this paper includes gendered and mainstream welfare state approaches and thus combines issues of gender and social inequality, as well as theories in the area of professionalisation. Empirically, the development of the new occupation is examined in two phases. In the first step, it looks at the time‐period between the 60s and 80s, when the stateoriented vs. family‐oriented principles of care for the elderly were established. The 90s brought about change in both countries. In Germany, with the introduction of the Long‐term Care Insurance, a new mode of care has developed, shared between informal family care, and public or private providers. In Sweden, budget restrictions in the 90s in this area led to a reorganisation, restructuring and reduction of the role of the welfare state. The consequences of the different processes in both countries will be discussed from the perspective of the predominantly female employees and the receivers of care. The results reveal a complex interaction between patterns of gender and social inequality and welfare state policies for the carers and care receivers.

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