The purpose of this study was to understand what is meant by spiritual care (andlig vård) as structured within the founding statutes and guidelines of the hospital church (Sjukhuskyrkan), the correctional services (Kriminalvården), and the health care services (hälso- och sjukvården) in Sweden. How the possibilities and limitations of spiritual care in Sweden are made visible from a socio-religious perspective is an overarching research question that forms the basis for the three sub-questions on how spiritual care is defined, designated and structured. The basis for the empirical material is partly text material from laws, presentations, guidelines, directives and basic documents for spiritual care and partly interview material from selected informants.Parts of the Constitution of Society by Anthony Giddens (1984) became the theoretical perspective. The method chosen emanated in the qualitative methods of Kirsti Malterud. The conclusions are that the structure for spiritual care in Sweden is strictly community-centered, and is reproduced through the individual actors, where the dominance of the Hospital Church maintains another ongoing and changing social system in spiritual care. This can create an unbalanced social structure in the arena of spiritual care. SST, Myndigheten för stöd till trossamfund (the Swedish Agency for Support to Faith Communities) and the Hospital Church have the means of power through the external caregiver structure on which spiritual care is based. This structure applies in a similar way to the spiritual care within the Swedish Prison and Probation Service, that reports structural imbalances that can lead to social vulnerability, discrimination and intolerance in prisons and demanding a Swedish vocational education. A clearer, patient-centered, approach is pointed out in this study, where patients with an existential crisis can be treated with either a general spirituality or a religious spirituality, where the concept of existential health through existential support can then be about both spiritual care and nursing.