I consider policy trends and the provision of home care for frail elderly people in four countries: Denmark, the United Kingdom, Germany, and the United States. The differing natures of the health and social services systems of each country and the welfare ideologies that underlie them have affected the expansion of home care for this group of people. Hence, Denmark--and to a lesser extent Britain--has relatively well developed networks of home care services, in contrast to Germany and the United States. However, any significant shift away from predominantly medical and institutional care to more home-based, social care is highly unlikely.