One in two home care workers in Sweden express a desire to leave their jobs. Home care provision and needs assessment increasingly work according to an assembly line logic, depriving care assistants and assistance officers of discretion, and putting care recipients at risk for social exclusion and neglectance. A field study of Moldovan home care indicates, in comparison, that admitting care workers a higher level of autonomy and self-determination contributes to the attractivity of social work and higher quality for beneficiaries, but the dominant care logic in Sweden is instead one of proletarianization: both needs assessment and home care interventions are organised according to manuals, forms, guidelines, and digital recording and scheduling logics. Drawing on findings in Moldova, further research into the role of discretion in social work with elderly is suggested. Findings also indicate that manual-based needs assessment risks resulting in people-production as formulated by Holstein.