CLOSER TO HOME (OR HOME ALONE) - THE BRITISH-COLUMBIA LONG-TERM-CARE SYSTEM IN TRANSITION

Finding ways to organize and deliver long-term care that provides for quality of life at an affordable price is of increasing importance as the population ages, family size decreases, and women enter the workfo rce. For the past 2 decades, British Columbia has provided a model sys tem that has apparently avoided disruptive conflicts. Although formal users' complaints are rare, this study-based on focus groups and inter views with users, their families, and advocates-identified problems us ers encountered toward resolving concerns about the structure, process , and outcome of long-term care. We present these findings in the cont ext of British Columbia's current devolution from provincial to region al control that aims to save costs and keep disabled elderly persons i n the community. British Columbia may be continuing to lead the way in meeting the needs of its burgeoning elderly population for longterm c are. Study findings have implications for the development of US long-t erm care policy by pointing to the value of obtaining users' views of long-term care to identify both obvious and more subtle trouble spots.