Constructions of elderly people's perceived needs for community-based long-term care

Information gained from elderly people regarding the constructions of their needs for community based long term care (CB-LTC) is necessary for informed and responsive policy and program development. It is essential given the demographic projections for the elderly population and the need to develop alternatives to institutionalization.; The purpose of this inquiry was to determine, from the point of view of elderly people, what community based services they would need to avoid institutionalization. Programs that exist nationally have been developed based on providers' conceptions of services which are necessary to maintain elderly people at home. There is a lack of information about services elderly people perceive they need.; Data were collected from nine elderly residents of a mid-western community who represent the phenomenon of at risk for institutionalization. Participants were interviewed serially and contingently in stages using naturalistic methodology. All participants were interviewed in their homes and asked to share their constructions of their perceived needs for CB-LTC to enable them to remain at home. The interviews were tape recorded, transcribed verbatim and analyzed by the inquirer.; Findings of the study indicated that the desire of elderly people to stay at home is motivated by their need to maintain control over their daily lives, their finances and their possessions. They are able to coordinate a number of formal and informal resources to be able to stay at home. However, the services they depend upon are not available for emergencies and on the week-end. Family members are essential for social contact and for provision of services, especially at times when formal services are not available. Elderly people endorse the need for options to nursing home care, but are unable to provide specific examples of alternatives.; The findings of this inquiry suggest policy implications for community based - long term care, for family caregivers, for formal and informal providers of care to elderly people and for nursing homes.