Hydra Revisited

Abstract

In response to concerns among policymakers and others that increases in the availability of publicly funded formal services will lead to reductions in self- and informal care, this study examines the relationship between the extent of formal in-home care received and levels of self- and informal care. Two-stage least squares regression analyses were conducted, using data drawn from interviews conducted with a sample of 661 older users and nonusers of publicly subsidized home care services. No evidence was found to indicate that more extensive use of formal services is associated with less extensive self- or informal care. This is true among those receiving publicly subsidized services as well as those required to pay part or all of the cost of the in-home services they receive. The findings provide little support for the substitution hypothesis that an increase in the use of formal in-home services will tend to erode levels of informal or self-care.