The complexity of the issues involved with providing appropriate health care and social services from the appropriate setting to people over age 65 can hardly be overstated. One of the present debates in the field focuses on the value of institutions as the customary setting for providing health care; the arguments are based on considerations of economic efficiency and the recipient's quality of life. Some of the debators suggest deinstitutionalizing as many of the health care recipients as possible, while simultaneously upgrading the quality and quantity of home based support services. The logic of deinstitutionalization is often buttressed by claims that either a greater level of services can be provided for the same dollar amount or the same level of services can be provided while permitting the expansion of services in other areas. Advocates of deinstitutionalization suggest that the quality of life can be increased for those people who can retain a greater independence over their lives by taking advantage of home based support services, rather than being more dependent in an institution. They suggest that all too often an older person is subjected to greater dependence in many areas solely because the person needs assistance in some specific areas.
Branch, Laurence G., "Understanding the Health and Social Service Needs of People Over Age 65" (1977). Center for Survey Research Publications. 5.