Equal for all? : A study of the alignment between communal guidelines on home care services and the Social Service Act (SoL)

Abstract: This study explores how municipalities in Sweden interpret and apply the Social Services Act in their provision of eldercare, specifically in their original place of residence, which has been their responsibility since the 1992 elder care reform. Despite a national ambition for equal eldercare provision, municipalities have significant flexibility in shaping their own guidelines based on local conditions. The study contains a content analysis of 23 communal guidelineswhich were selected based on the municipalities’ size, geographic location, and population patterns. The guidelines were analyzed using Max Weber's concept of bureaucratization and identity theory. Notably, a significant proportion of the analyzed guidelines contain explicit time intervals for the home care interventions that are typically provided within the municipality. The study's key findings highlight substantial variations in these interventions across municipalities, encompassing differences in the types of interventions offered, as well as variations in their frequency and designated time intervals. It is reasonable to assert that the variations in home care interventions identified in this study bear significant consequences for older adults that seek home care, depending on their municipality of residence. This paper highlights the significant importance of guidelines in shaping the variations in home care services across different municipalities. It also seeks to promote further research and encourage broader discussions on the governance of eldercare in Sweden.