One 100 year-old woman had her own fist shoved into her mouth. An 85 year-old had white crawling larvae in her infected sores. A sick elderly man received a wrong dosage of insulin.

Reports of maltreatment of elderly are increasing in many parts of the country, despite the fact that Sweden spends more money on geriatric care than any other OECD country.

“We’ve reformed the entire regulatory organisation, and a larger responsibility now rests with the National Board of Health and Welfare,” explained Maria Larsson, minister for children and elderly.

“Previously we haven’t had a national overview of the situation, which we do now. The process needs to be open, and it’s important that nothing gets swept under the rug.”

“Generally speaking our geriatric care in Sweden is good, we notice that when we speak to the patients themselves. Of course, there are flaws and singular cases, and that’s why we need to be open, in order to discover and prevent these,” said Larsson.

Nearly 200 reports of maltreatment, at nursing homes and in geriatric care, were made to the National Board of Health and Welfare’s regional offices last year. Most came from patients’ relatives.

“Smaller issues should be corrected by the counties’ own quality checks, only the bigger mistakes are brought forward to us. This could be severe risks, life-threatening mistakes, administering the wrong drug, or staff acting in an inappropriate manner,” explained Gert Alaby, coordinator of elderly care issues at the National Board of Health and Welfare.

However, very few reports have led to the authority demanding direct measures. Instead, the responsibility for correcting flaws is often shuffled over to counties.

Region Mitt, an area covering the counties Uppsala, Gävleborg, Västmanland and Dalarna, received 36 complaints between 2010 and 2011. Only eight of these led to action.

For Region Öst, which is Stockholm and Gotland, the authority only demanded that measures be taken in five of 56 cases. Even so, in every case, a dialogue is held with the county, about how best to solve the problem.

“Counties are now responsible to ensure the problem is solved, and mistakes corrected. But if this doesn’t resolve the situation, we are now able to both prohibit businesses and fine them,” said Larsson.

New legislation, brought into effect July 1st this year, counties are obliged to report lex Sarah-cases, reports of maltreatment within geriatric care, to the National Board of Health and Welfare.

However, the tendency to report varies from county to county.