Social care: family and community support systems.

The growing number of elderly is bringing about dramatic changes in family life, in the nature and extent of interventions necessary to support an aging population, and in our notions about respective roles of family and community in providing for these needs. Although most older people manage independently with only the ordinary assistance family members provide each other, growing numbers of the oldest old and persons suffering from frailty and incapacity require more extensive social care. The term "social care" is often used synonymously with "formal community services," but the concept is broader, also encompassing informal family care. Social care is directed toward needs critical to independence: socialization and self-development, help in tasks of daily living, and assistance with personal care. At present, older people prefer that social care be provided within a family context, turning to formal community interventions only when families are unable to provide the required assistance. But given increases in numbers of working women, the restructuring of the family, and changing attitudes about the community's role as service provider, a more carefully articulated partnership between family and community will be required in the future.