Health: support provided and received in advanced old age. A five-year follow-up.

While research focuses mainly on support provided to the elderly, this paper deals with the very old as a support provider to his family as much as a care recipient from both his family and a formal network. We hypothesize that elders with declining health will try to maintain the provision of services, even when they require and receive help.A total of 340 octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) were interviewed up to five times over five years (N=1225 interviews). A multilevel model was applied to assess the effects of health, controlled for socio-demographic and family network variables, on the frequency of services that the old persons provided to their family and received from their family and formal networks. Health is operationalized in three statuses: ADL-dependent, ADL-independent frail, and robust.While the recourse to the informal network increased progressively with the process of frailty, the recourse to the formal network drastically increased for ADL-dependent individuals. Being ADL-dependent seriously altered the capacity to provide services, but ADL-independent frail persons were providers with the same frequency as the robust oldest old, showing their ability to preserve a principle of reciprocity in their exchanges with their family network. This continuity of roles may help frail persons to maintain their self-esteem and well-being.