Swedish seniors receive more ADL help than elderly Americans

Nursing Homes, Nov, 2003

Sweden's long-term care system may have lessons for Americans on providing ADL assistance to seniors living in the community. A study published in the October 2003 issue of The Gerontologist ("Exploring Assistance in Sweden and the United States") found that 60% of surveyed Americans age 75 and older reported receiving no help for an instrumental ADL (shopping, housekeeping, etc.) or personal ADL (feeding, bathing, etc.), compared to only 4% of similarly aged Swedes. Although both countries provide support to approximately 40% of their populations over age 75, "Our results show that the system of long term, community-based care for the oldest old favored in Sweden is much more effective at meeting people's needs than the short-term post-acute care or institutional care typically offered in the U.S.," said Dr. Dennis Shea, professor of health policy and administration at Penn State and lead author of the study.

"One of the clear patterns is that few people in Sweden who report a specific ADL need, fail to receive assistance for it; in the United States, a substantial portion of people with needs receive no assistance, and many people who report no long term ADL need do receive assistance," the researchers wrote. A grant from the AARP Andrus Foundation supported the study.

Some U.S. states are focusing on the type of care provided by the Swedes--using long-term, community-based services--and Shea plans to determine whether those states have lower levels of unmet need.