Informal and formal long-term care for frail older adults in Cairo, Egypt: family caregiving decisions in a context of social change.

This paper explores the factors that lead family caregivers to place their frail older relatives into long-term care centers in Cairo, Egypt despite norms of family care. Semi-structured interviews were conducted with 18 "case" caregivers who placed their older relatives into long-term care and 17 "control" caregivers who provided for their older relatives at home. Cases and controls differed in their relationship to the older adult, number and proximity of supportive siblings, and perceived health status of the older adult. Caregivers who used long-term care justified their decision by stressing the need for relief from the burden of caregiving, and by conceiving long-term care as part of a broadened definition of family care. Egyptians are devising new strategies of care despite persistent norms of reciprocity among kin. As demographic, epidemiologic, and socioeconomic changes continue, families may adopt new combinations of care to support their frail older relatives. Findings underscore the need for population-based research about strategies of caring for frail older relatives in this context.