A survey covering all the elderly over 65 years of age at home and in institutions was made in a rural town of Japan in order to reveal the physical and socio-psychological factors which were related to their current placement status. The proportion of those over 65 in this town is 13%, of which 53% are living either alone or with spouse only, which anticipates the future national trend. Of the 3039 enumerated, 6.0% were hospitalized, 1.5% in the Home for the aged and only one in a Nursing home. As the level of disability became more serious, the proportion institutionalized increased; however, even at the severe level only half were in institutions. This situation could only be understood when the family caring capacity was taken into consideration. Those at home had a greater possibility of having a healthy, not employed caring person. Economic factors were relevant only for the Home for the aged subjects. At the same disability level, the family of the institutionalized expressed a greater subjective burden in caring compared with those at home. A tentative criteria for evaluating institutional care need based on the level of disability and family caring capacity is proposed.
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