Abstract:

This study examines how institutionalisation of older people is influenced by changes in carers' capacities and motivations to care. Longitudinal data were available from case manager assessments for 632 highly dependent older clients of intensive community services. The likelihood of entry to an institution over 19 months was found to be significantly and independently associated with ratings of both reduced carer capacity and reduced carer motivation. Important factors in reduction of carers' motivation were client dementia and behaviour problems and the age and initial level of the motivation of the carer. While client hospitalisation and inadequate help with client activities of daily living predicted reduction of carer's capacity to care, client use of respite predicted loss of carers' motivation. The findings demonstrate the importance of professional practice which meets specific needs of carers as well as older clients and their families.