Is family care on the decline? A longitudinal investigation of the substitution of formal long-term care services for informal care.

The focus on rising costs of long-term care now encompasses community as well as institutional care. Policy makers cite the potential impact of changing social trends on informal caregivers' availability to continue as the main source of care and the possibility that formal services will then replace this informal care. They fear that families will relinquish their caregiving role if publicly funded home care services are available. Longitudinal data from a sample of disabled elders were used to investigate the substitution of formal services for informal care over a seven-year period. The substitution that was detected could be traced to the limited availability of informal care, and it represented a temporary change in the informal care pattern rather than a permanent replacement for it. Instead, use of formal services has supported the elderly person's continued residence in the community.