[Resolving real dilemmas in the elderly. A comparative study in an Argentinian community]

To assess whether the differences in making decisions in real dilemmas between the institutionalised elderly and those living in the community are dependent on the context and life history, as well as on its development and subject matter.

Qualitative and cross-sectional study on resolving real life dilemmas using interviews and story life. Two groups were assessed, each one with 40 elderly participants aged 65 and over, one group who lived in the community and attended a Retirement Centre, and the other group living in a Long term Care Facility, in Rosario (Argentina). Answers to dilemmas in hypothetical and real contexts were assessed and were mainly about family, politics, welfare, support, authority, personal coherence and life satisfaction topics.

Most of those residing in the Long Term Care Facility reached a conventional stage of moral reasoning, and the main topics were family, support and socio-political issues. Those living in the community reached conventional and post-conventional stages and the main topics were authority, personal coherence, and family, the latter with a negative trend. Social conditions and experience had a great influence on those living in the community and isolation in those living in Care Facilities.

a) Moral reasoning depends on life contexts, b) it is not stereotyped, c) this knowledge must be incorporated into adult education programs in order to understand their developments from their own point of view and d) obtain a commitment from the rest of the society towards integration of the elderly, accepting their ethical postures even if these do not match current thinking.