Abstract:

A discussion of the changes in levels of need, types of care, & potential future services for the old-old (the frail elderly) in the past fifteen years in the U.S. The efforts & actions of the Federal Council on the Aging are described, & a series of demographic & programmatic trends are discussed, eg: (1) the increasing numbers of older persons; (2) rapid improvement in their economic status; (3) the increasing complexity of the gerontological services network; (4) limits of caregiving capacities of spouses & offspring; (5) inadequacies in existing community services; & (6) challenges to community workers brought about by technological advances in community-based treatment. Staffing, training, & the organizational design of the community-based service sector are addressed, leading to discussion of possible guidelines for community-based care for the oldest-old.