In Sweden, the public home help services (PHHSs) have been given to the elderly to live at their homes as long as they do not need a comprehensive supervision and care since 1960. The PHHSs in Sweden led to the change of care paradigm from institutional care to care at elderly's own home, resulting in that the responsibility of caring for the elderly is transferred from the family to the public domain to a great extent. However, the PHHSs in Japan were not well developed until the early 1990s. Many factors, such as collective familiar responsibility on elderly care and shared negative attitudes toward the public welfare services among other things, have contributed to the late development of public welfare services for the elderly in Japan. The practices of the elderly care in both countries are recently questioned in context of structural changes. The PHHSs are now getting harder and harder because of both shrinkage of the family size and increase of women's participation in the labor market in Japan and because of the shrinking economy together with the growing number of oldest old led in Sweden. Consequently, those structural changes forced politicians in both countries to deal with the elderly care problems.