Returning Home from Residential Care? Patient Preferences and their Determinants

Abstract

The objective of the study was to discover what fairly independent residents living in long-term residential care think about home care as an alternative. A stratified systematic sample was drawn from a one-day census of patients in all residential homes in Finland on 2 December, 1991. A postal survey was used for data collection in December, 1992. Respondents who preferred home care were compared with respondents preferring residential care according to length of stay, health, functional ability and health-related quality of life. Most respondents preferred institutional care. Preference for home care was explained most strongly by emotional factors, unwillingness for residential care at admission, and still having a home to return to. Shorter length of stay also predicted preference for home care. Those who preferred home care admitted they would need much formal care after discharge. People living in residential homes are rarely ready for discharge home, because of limitations in their physical ability or of their unwillingness to change their site of care.