Changing patterns of care among older adults with care needs: Subgroup variations in formal, informal, and privately paid care in Sweden

Abstract The Swedish welfare model emphasises universal access to publicly provided old‐age care, yet demographic change, policy developments, and rising socioeconomic disparities have altered the balance between formal, informal, and privately paid care. Focusing on community‐living individuals aged 77+ years with limitations in instrumental activities of daily living (IADL), this study examines how formal and informal IADL care has developed over three decades. Using repeated cross‐sectional national data from Sweden between 1992 and 2021, differences by gender, education, household composition, and functional limitation were analysed, and privately paid care assessed. The results indicate a long‐term decline in home care services, alongside a growing reliance on family care, particularly partner‐provided care, even among individuals with more severe functional limitations. The use of privately purchased care has increased, especially among women and persons with higher education. Taken together, these patterns point to widening inequalities in access to care in the Swedish welfare model.