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 1960s and
1980s, when the state-oriented vs. family-oriented principles of care for the elderly were
established. The 1990s 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 1990s 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.