Nursing load in different care alternatives in Sweden during 18 years

In a repeated cross-sectional study, changes in nursing load and changes in care organisation (1978-1996) were studied in Sundsvall, Sweden. A total of 4555 nursing load measurements on elderly people were performed on four occasions (1978, 1988, 1993 and 1996). The nursing load has increased considerably at the nursing homes and at the homes for the aged during the whole period. In home care, the nursing load did not increase between 1978 and 1993, but it increased considerably between 1993 and 1996. The mean age of the residents, the number of persons with dementia, as well as the mean age, also increased. Between 1978 and 1996, the number of institutional resources decreased by 38%, while home care resources increased by 421%. The considerable increase in nursing load presents a worrying scenario when it is combined with the expected increase of the oldest old.