The Elderly Act does not just change the organization of elderly care. It also challenges roles, relationships, and ways of working. Authority staff, in particular, are in the midst of a difficult transition, the consultants write.

A year has now passed since the elderly reform came into effect on July 1, 2025. The reform marks a break with the traditional way of thinking about management, professionalism, and collaboration. In municipal elderly care, this means the task is not just to implement new workflows, but to support a deeper cultural change where employees must apply their professional expertise in new ways.

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This entails a new role for authority staff and a shift from specialist to facilitator. The transition to a new professional identity requires organizational support, skills development, practical trials, and a common language for what good facilitation and professional support entail in practice.

From individual services to holistic care pathways

With the Elderly Act, there has been a shift in who makes ongoing decisions regarding help and support for the elderly. While the authority function previously determined the content and scope of care to a greater extent, home care staff now have greater professional leeway to continuously adapt the support to the citizen's current needs.

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This means that the help can be adjusted more closely in line with the citizen's situation, based on the dialogue between the citizen and the staff who know them best. The authority still makes decisions regarding the overall care pathway offered to the citizen, but the concrete adjustments to the help are increasingly taking place in daily practice.

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This involves an expansion of actual administrative activity. Employees are not making new decisions about the citizen's rights, but are taking on greater responsibility for translating the overall framework into concrete support in everyday life. At the same time, this development places increased demands on the employees' professional judgment. When more decisions are made close to the citizen, the ability to balance the citizen's wishes, professional assessments, and the legislative framework becomes crucial to the quality of the care.

The professional role in transition

The Elderly Act rightly calls for less authority, but at the same time, we see potential for the professionals who handle authority tasks today to also take on other important roles in the future.

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While the role of authority staff was previously closely tied to assessment and decision-making, there will be a future need for competencies that can support the realization of the Elderly Act's core values: self-determination for citizens, trust in employees, and interaction with civil society.

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In this transition, authority staff can take on a central facilitating role as professional sparring partners. They often have extensive experience with interdisciplinary collaboration, coordination across organizational boundaries, managing complex citizen cases, and navigating dialogues characterized by dilemmas, conflicting interests, and difficult trade-offs. These are competencies increasingly in demand among home care staff as they take on greater responsibility for exercising professional judgment and adapting help to the individual citizen's situation.

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This requires a shift in role, relationship, and communication style. Where the relationship was previously often defined by the authority's formal decision-making power, the new role calls for more equal collaborative relationships. At the same time, uncertainty regarding responsibility, mandate, and expectations can arise when the boundaries between authority, sparring, and professional support become less clear.

A challenging shift in roles

This represents a significant and difficult shift in roles for many public sector employees. Traditionally, the role has been defined by the employee being brought in as a specialist to make difficult decisions, interpret legislation, or find solutions to complex problems. This has fostered a professional identity where value has largely been tied to possessing expert knowledge and being able to provide answers, clarifications, and solutions.

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The facilitating role is based on a different logic. Here, the task is not primarily to solve problems yourself, but to support others in handling them through interaction and dialogue. The public sector employee must contribute more to reflection, learning, and collaborative problem-solving among home care staff, rather than providing instructions, advice, and case resolutions.

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For many public sector employees, this can be difficult because they are required to act in ways that may feel less natural than the working methods they have been trained in and recognized for over many years. When you are used to being valued for having the answers, it can feel unfamiliar to create value through questions.

The transition has only just begun

The Elderly Care Act does not just change the organization of elderly care; it also challenges roles, relationships, and working methods. However, a number of questions remain open. How do we best support the professional judgment of staff without reintroducing unnecessary control? How do we create clear frameworks for responsibility and decision-making authority in interdisciplinary teams? And how do we develop the public sector role so that its competencies are brought into play in new ways without losing the strengths that already exist?

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The answers will necessarily look different from one municipality to another. But if the intentions of the Elderly Care Act are to succeed in practice, it is crucial that leaders and employees dare to experiment with new roles, relationships, and forms of collaboration – while maintaining a focus on the common goal: to create an elderly care sector where self-determination, trust, and professional quality go hand in hand.