The Family in the Institutionalization of the Elderly

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Abstract
Family caregiving to elderly impaired members is so ubiquitous that there are more homebound than institutionalized elderly. The burden on families who provide care to impaired elderly family members can be enormous but it can be reduced through extrafamilial assistance. Institutional care is often sought when the burden becomes overwhelming; and if institutionalized, the older person cannot avoid feelings of abandonment, and the family, feelings of guilt. Family involvement persists after the elderly person enters and lives in the institution. Although it can be expected that families will continue to be committed, willingness to provide home care may diminish because of changes in family caregivers: more daughters are likely to be working and more children likely to be elderly themselves and to be members of non‐intact families who may perceive familial obligations differently. It is unlikely that community based services can reduce the need for institutional care among those residual elderly who will not have family to care for them at home and who will have virtually no potential for restoration to the activities of everyday life.