Objective: To determine how well outcomes could be predicted by initial cir
cumstances and subsequent deterioration in clients and carers.
Method: Longitudinal data from the Victorian Linkages projects, collected i
n 1992 and 1994, were examined.
Results: Institutionalisation was highly likely in eases where carers exper
ienced reduced motivation to care. Placement in nursing homes rather than i
n hostels was best predicted by incontinence. Death was associated with cha
nges in health status. Those clients most successful in avoiding long-term
institutional care were in stable situations with a spouse carer.
Conclusion: The study provides supportive evidence of the capacity of inten
sive community services to provide alternatives to entry to residential car
e.