Sustainable eldercare in the Nordic region: Educate, recruit and retain

On April 3^rd 2025, the Nordic Welfare Centre gathered experts from across the Nordic region at a seminar in Nordens hus, Copenhagen and online. Participants represented ministries, health and social authorities, trade unions, municipalities, research and senior citizens across the Nordic region. Building a sustainable eldercare is a pertinent question for the Nordic welfare states, and there is much to learn from looking across borders.

Equal access to social and health care and healthcare services needs to be secured, both across the geographical variations of both urban, rural and sparsely populated areas in the Nordic countries, as well as for older people with different ethnic backgrounds, gender and sexual identities. Collaboration across sectors and digital solutions are central components in this endeavor. The seminar focused on three interconnected themes: education, recruitment, and retention. These themes were reflected in presentations and discussions around skills development, diverse recruitment strategies, and models for self-governing teams.

Skills development as retainment

Flexible, accessible, and partly digital education models were highlighted as key to increasing the number of skilled care professionals at municipal and regional level. Michael Kümmel from the Association of Danish Healthcare Colleges presented a programme supporting customized training tailored to learners’ backgrounds and needs. The programme emphasizes on-the-job learning, local partnerships, and accessible pathways for unskilled workers and those with limited language proficiency. It operates through cross-sectoral collaboration, with partners from municipalities, regions and trade unions. Training is structured to avoid overburdening already stretched care teams.

Language training was a recurring theme throughout the seminar discussions. Different methods for working with language requirements for people who do not speak the native language was presented, ranging from language as a requirement to enter a workplace, to informal language training as part of an ongoing skills development after recruitment.

Diverse recruitment strategies

Recruiting among groups of people with no formal education from the sector can be a way to increase the workforce, for example people with a migrant background, young people and people in search of a second career. This requires adequate training and support, both in terms of professional skills as well as language.

In their presentation, Palle Storm, Stockholm University, and Maria Wolmesjö, University of Borås, have studied two recruitment models through participatory action research: the FAVO model from the Region of Gothenburg and Telge Tillväxt from the Municipality of Södertälje. Both aim to support recruitment and skills development among people with a migrant background, many of whom face barriers such as limited language proficiency or formal training.

The FAVO model focuses on social and healthcare competencies, with individual competence plans and mentorship. Telge Tillväxt offers a structured four-step recruitment and onboarding process, beginning with language and social and healthcare skills and progressing to training and employment.

Storm and Wolmesjö emphasized that these models are not only about recruitment, but about long-term integration and retention. They illustrated how structured onboarding, mentorship and inclusive training pathways can improve both employment outcomes and workforce stability.

Self-governing teams: Autonomy, satisfaction, and the role of leadership

Self-governing care teams were highlighted as a way to increase both work satisfaction and quality of care. Emmy Hjort-Enemark Topholm from the Danish Center for Social Science Research (VIVE), presented models of interprofessional, self-managing home care teams. In these teams, employees take ownership of daily work planning, holiday scheduling, and organizing services into larger care packages. Managers shift into supportive coaching roles, helping teams take greater responsibility and flexibility. Among other things, this approach has been seen to increase coherence and holistic approaches to care, as well as professional development for care workers especially. Moving forward, challenges remain around managing self-governing teams and how to ensure adequate support for the frontline managers.

Timo Sinervo, from the Finnish Institute for Health and Welfare, also emphasized that successful self-organization requires supportive coaching leadership, manageable team sizes, and continuity of care. Sinervo illustrated that stress, sick leave and early retirement remain high in eldercare, but empowering teams, especially in nursing homes can be part of the solution if accompanied by structured support.

Building sustainable eldercare through Nordic collaboration

As Nordic countries confront the complex pressures of demographic change, labour shortages, and care needs from a growing older population, the seminar made clear that securing a sustainable eldercare system requires coordinated efforts across sectors and borders.

Presenters illustrated how flexible training models and inclusive recruitment strategies can open doors for people from diverse backgrounds, including those with limited formal education or language skills. Giving care teams greater autonomy through self-governing models can lead to better work environments and more person-centred services, when paired with appropriate support structures and leadership development.

Collaboration emerged as a central theme, whether across sectors, between professionals, municipalities and trade unions or between education providers and care employers. Continued dialogue, learning and cooperation across the region also remains a key component in creating a sustainable eldercare in the Nordic countries.