Limit of support and reaction to illness: An exploration of black elders' pathways to long-term care settings

This paper explores the differences between apparently similary impaired black elders who either were placed in nursing homes or received in-home services. The two groups differed most consistently in how they talked about the progression of their illness and how they described their reaction to it. Home care clients had experienced illness for a long time; they struggled for independence and were determined to define themselves as competent. In contrast, nursing home residents portrayed themselves as having been toppled by a health crisis; they defined themselves as incompetent and accepted others' definition of them as incompetent. The two groups also differed in the limit of their informal support. It is suggested here that the concept of the limit of support adds a useful dimension for exploring the relationship between institutionalization and informal support. It is also suggested that the participants' perception of their functional status and of their informal support was influenced by their health histories.