Abstract:

A prerequisite to preventing premature institutionalization is an understanding of the strategies used by the elderly, or by agents acting on their behalf, in coping with the effects of declining health & functional capacity. Available data suggest that the rural elderly exhibit higher prevalence of disease & disability & express more concern about their health than their urban counterparts. The effect of higher prevalence of disease & disability is exacerbated by the more limited range of health & social services in rural communities. Focus is on the contribution of informal support networks in the long-term care arrangements of the noninstitutionalized rural elderly. Strengthening these informal networks has several advantages over an exclusive focus on formal services, particularly in rural areas where program implementation must face a number of logistical issues. From an economic perspective, family, friends & neighbours represent a significant source of low-cost labor for providing support services. A more subtle advantage relates to the social psychological impact of receiving help. Formal services place the elderly person in the role of dependent recipient, without providing any mechanism for reciprocity. Using a social exchange perspective, one would predict that opportunities for reciprocity within the informal network would contribute to the older person's ability to maintain more nearly balanced relationships with informal helpers, thus contributing to the older person's sense of independence & leading to higher levels of life satisfaction.