[The elderly and the use of home care. Past, present and future].

Home help is supposed to be one of the most important instruments for the sustained independency of the elderly. It is true that home help is a general provision, but because of the ongoing ageing of the population, it becomes a provision with mainly elderly clients (60%). In percentages of population the importance of home help increases with age and achieves a maximum for people of 80-84 years (15%). Clients living by themselves are the most important group (70%). Two thirds of the elderly clients have a public pension as (maximum) income, which explains the low contribution of client fees to the total costs. On average, they account for 14.7% of the costs for alpha service and 7.6% of the costs for traditional home help. Clients receive home help for more than three years, which is not only influenced by marital status (clients living by themselves 50% longer than other households), but also by age (the older, the longer). Within the group of elderly clients we found a positive relation between clients' age and total help in hours per week and in years of care. The ongoing greying will cause an increase in the number of clients with an average of 1.8% per year until the end of the century. Improvement of efficiency and diversification of provisions could partly mitigate the expected financial pressure, but because of the (intended) incorporation of home help services in the social insurance package (AWBZ), policy makers will have to pay attention to the financial consequences of population ageing for the home help services.