Substitution between formally and informally provided care for the impaired elderly in the community

This article assesses the extent to which formally provided comprehensive community care tends to substitute for informal care provided by family and friends to impaired elderly persons living in the community. Using simultaneous equations causal modeling techniques to control for selective targeting and other intervening factors, results indicate a substantial tendency for formally provided care to be substituted for informal care. Other results indicate that unmet need appears to be the major variable predicting both informal and formal support levels, with informal care providers appearing to be somewhat more precise in conditioning support levels on need than formal care providers. Policy implications of these findings are discussed.