Abstract:

The objective for this study was to determine how well outomes could be predicted by initial circumstances and subsequent deterioration in clients and carers. Institutionalisation was highly likely in cases where carers experienced reduced motivation to care. Placement in nursing homes rather than in hostels was best predicted by incontinence. Death was associated with changes in health status. Those clients most successful in avoiding long-term institutional care were in stable situations with a spouse carer. This study provides supportive evidence of the capacity of intensive community services to provide alternatives to entry to residential care.