Formal services and informal helping: the myth of service substitution

I examine the relationship between formal and informal assistance among a sample of elder-caregiver dyads living in a community setting in upstate New York. The data fail to support concerns that informal helpers withdraw their support when formal substitutes are available. Rather, formal services were used most frequently by more functionally impaired elderly whose caregivers were already providing personal care. Elders whose caregivers were employed reported more reliance on formal services, but being employed did not depress the level of informal support the caregiver provides.