The aim of this article is to illustrate the changes in the Swedish system of old-age care during the 20th century by tracing and analysing the history of the job of supervisor or manager of this care. The main sources that have been researched are public and educational documents as well as articles from the occupation's professional journal. Development through different periods is described. During the first decades of the century, supervisors had a controlling function in strictly disciplined poor-relief institutions. The period 1920–1950 was dominated by a strong belief in institution-based old-age care, and the supervisor's role had a variety of profiles, e.g. matrons of home-like institutions, geriatric nurses, and manageresses of increasing numbers of care-staff. The decades 1950–1980, were characterised by expansion and new arenas, chiefly the home-help services. In the 1990s, with a strained public economy, the financial control became a central feature of the work of the managers. Finally, some of the changes and trends are analysed and discussed.