Who are those most likely to be institutionalized, the elderly who receive comprehensive home care services or those...

Three samples of clients aged 65 and over from three different home care and homemaker programs are compared to elderly persons with a risk of institutionalization chosen from three random samples of people aged 65 and over living in the catchment areas of the three programs. The most important differences between the clienteles and the populations with a risk of institutionalization appear when examining the availability of help. The populations at risk generally have access to a source of help living with the elderly person while the clienteles of comprehensive home care programs depend on outside help. Home care and homemaker programs therefore replace in-home services with out-of-home services. These services will be effective insofar as they succeed in reproducing some of the essential characteristics of in-home care.