IS HOME CARE A REALISTIC ALTERNATIVE TO RESIDENTIAL CARE AMONG INSTITUTIONALIZED ELDERLY PEOPLE IN FINLAND

The high rate of institutionalization among elderly people in Finland is widely discussed among policy-makers. We studied how realistic the wishes for deinstitutionalization are among the least sick elderly peo ple in residential care, and what patient characteristics predict whet her residential care is appropriate. This issue was assessed by the re sidential home personnel. Personnel assessment of institutional care a s appropriate was mainly explained by patients' needing help with medi cation, limitations in activities of daily living, absence of own home to return to, no Living children, incontinence, and poor vision. Disc harging elderly people from long-term residential care back to society is limited by factors such as inadequate housing and shortage of domi ciliary and rehabilitative services, as well as by attitudes among the institutionalized elderly people themselves. It seems more realistic to prevent the inappropriate institutionalization of elderly people th an to discharge the small numbers of fairly independent individuals al ready in residential homes.