[Why do elderly couples use ambulatory nursing care?].

More than one million people in Germany are in need of home care and elderly caregiving wives and their caretaking husbands are an important group in the society. Demographical changes with a shift to more elderly people in relation to younger people will further increase the importance of this group. Home care service organisations play an important role in supporting these couples, but they are still rarely made use of. To optimize the support that can be rendered by home care services, information is needed on what influences the decision of elderly couples to use or not to use such services. A set of data from an earlier study about the situation of more than 300 couples aged 60 years or older is used to determine influencing factors in bivariate and multivariate analysis. The theoretical framework is a behavioural model of service use. The need for care measured by loss of function in activities of daily living turns out to be the most important factor influencing the use of home service organisations. Other variables such as e.g. disability of caregivers play a minor role. It seems that home care services are used as a kind of "last resort" if there is no other way to handle the situation. In trying to optimize home care services, the different values of factors influencing their use should be considered. It is important to take into consideration that those who solicit home care aid wish to retain their autonomy at the same time.