Home Care vs. Institutional Care:

Making the Best Choice for the Elderly

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Abstract

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This study examines the choice between home care and institutional care for the elderly in Taiwan. A questionnaire was distributed online, collecting responses from 128 individuals, predominantly aged 40 to 65, including friends of the researcher’s parents and grandparents. Both closed-ended and open-ended questions were used to gather insights.

 

Results indicate that 50% of respondents see both care types as beneficial, 25% prefer home care for its familiar environment and family connections, 9.4% favor institutional care, and the remainder expressed no opinion. 50% Although institutional care showed low preference among respondents, it was highly valued for its professional medical support (81.2%) and its ability to relieve family caregivers (79.7%), as highlighted by concerns like caregiver burnout and insufficient training in open-ended responses.

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These findings highlight institutional care’s potential to address critical challenges in Taiwan’s aging society. To encourage broader acceptance, efforts are needed to raise public awareness, improve service personalization, and secure stronger government support. This study ultimately aims to persuade that institutional care is the superior option for meeting the needs of an aging population.

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I. Introduction

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The Ministry of Health and Welfare(2022) estimates that by 2025, Taiwan will become a “super-aged” society, with over 20% of its population aged 65 or older. This demographic shift is placing immense pressure on the nation’s elder care system, making the choice between home care and institutional care a pressing concern. In this context, it is essential to examine the relative benefits of each care model. According to a study by Miguel et al. (2016), the quality of life for people with dementia is often more positively impacted in institutional care settings, where professional medical support and a structured environment help reduce depressive and neuropsychiatric symptoms. This highlights the potential advantages of institutional care, particularly in addressing the complex health needs of elderly individuals.

 

However, despite these advantages, there is limited research comparing public preferences with the actual challenges faced by family caregivers and elderly individuals, leaving a gap in understanding the best approach to elder care. This study explores the critical question of which care model is better suited to meet the growing needs of Taiwan’s elderly population. Through an analysis of survey data, the research aims to persuade that institutional care offers distinct advantages over home care, particularly in terms of professional medical care, 24/7 supervision, and relief for family caregivers.

 

Institutional care provides professional staff, tailored services, and a structured environment that home care often cannot replicate. These features make it better equipped to address the multifaceted needs of Taiwan’s aging population. Therefore, Taiwan should prioritize institutional care over home care for the elderly, as it ensures better medical support, round-the-clock supervision, and alleviates the burden on family caregivers.

 

II. Methods

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1. Participants:

The questionnaire targeted individuals in Taiwan, primarily those with elderly family members or experience in elder care. 128 Participants included a diverse demographic range, with ages spanning from 16 to 65+, ensuring insights from both caregivers and decision makers.

 

2. Questionnaire Design:

The questionnaire included a mix of closed-ended and open-ended questions. Closed-ended questions utilized Likert scales and multiple-choice formats to assess preferences and experiences of home care and institutional care. Open-ended questions allowed participants to elaborate on their views and share personal experiences.

 

3. Data Collection:

Data was collected online via social media platforms, as well as through personal networks, including the my parents’ friends and grandparents. A total of 128 responses were gathered over the survey period.

 

4. Data Analysis:

Closed-ended responses were analyzed quantitatively to identify significant patterns and trends, while open-ended responses were analyzed thematically to extract common themes and unique insights.

 

III. Findings

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This section presents the findings from the questionnaire on elderly care preferences in Taiwan. It begins with the results of the closed-ended questions, followed by insights from the open-ended responses.The questionnaire result indicate that while many respondents value home care for its emotional benefits, institutional care is perceived to offer key advantages, such as professional medical support, 24/7 supervision, and relief for family caregivers.

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1. Closed-Ended Question Analysis

 

First, the survey results show that most respondents in Taiwan are more familiar with home care than institutional care.

According to the survey, 75% of respondents are familiar with home care (including “very familiar” and “somewhat familiar”), while 64% are familiar with institutional care. See table 1.

 

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Table 1

 

When asked about the advantages of each care option, 79.7% of respondents identified a familiar living environment as the primary benefit of home care, followed by 68.8% citing family bonds and support, and 61.7% highlighting more personalized care. On the other hand, institutional care was recognized for its professional medical care by 81.2% of respondents, relief for family caregivers by 79.7%, and social interaction with peers by 44.5%. See table 2.

 

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Table 2

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Additionally, 50% of respondents believe both home care and institutional care are beneficial, while 25% think home care is more beneficial, and only 9.4% favor institutional care.

 

2. Open-Ended Question Analysis

 

The open-ended responses highlight several prominent themes regarding the improvement of elderly care in Taiwan and other related concerns. These themes focus on increased government support, caregiver challenges, and the need for more accessible and diversified care options. See below for details.

 

Increased Government Support:

 

Many respondents stressed the need for increased government subsidies and more diversified funding for elderly care. They noted that current support is insufficient, and there is a desire for more targeted subsidies that cater to various needs, including mobility and health requirements.

• One participant noted that government subsidies are currently too few.

• Another suggested that subsidies should be adjusted to meet different needs, such as health conditions or levels of mobility.

 

(1) Caregiver Support and Training:

There is a clear call for improving caregiver support, both in terms of increased benefits and professional training. Respondents frequently mentioned the shortage of qualified caregivers and the stress placed on family caregivers, suggesting that improved empathy and better pay could address these issues.

• A respondent expressed the need for better caregiver professionalism through enhanced training programs.

• Others emphasized the importance of increasing caregiver benefits to encourage more people to join the profession.

 

(2)Accessible and Diverse Care Option:

Several respondents pointed out that elderly care should be more accessible and personalized to cater to the varying needs of the elderly. Many called for more care facilities that can accommodate individuals with limited mobility or specialized care needs.

• Five responses expressed frustration over the lack of long-term care institutions, particularly for those with mobility issues.

• Others mentioned that subsidies should be tailored to support different levels of care requirements.

 

(3) Health and Well-being of the Elderly:

The physical and mental health of the elderly were frequent concerns. Respondents emphasized the need for mental health services and health education programs to help maintain the elderly’s independence and overall well-being.

• One respondent suggested focusing more on the mental and physical health of the elderly in care programs.

• Another mentioned the value of promoting elderly education to help seniors take better care of themselves.

 

(4) Social Integration and Activities:

Creating opportunities for social integration and community-based activities was another recurring theme. Respondents suggested that institutions or communities should regularly host recreational programs to promote mental engagement and reduce isolation.

• A participant proposed organizing community events tailored to elderly people, fostering connections among peers.

• Another respondent remarked that institutions should strive to create inviting environments where the elderly would feel encouraged to participate.

 

IV.Discussion

 

While institutional care is recognized for its professional medical support and caregiver relief, 25% of respondents believe home care is more beneficial, citing its ability to provide a familiar living environment (79.7%), strengthen family bonds (68.8%), and offer personalized care (61.7%). This suggests that many individuals value the emotional comfort and sense of connection that home care provides, which institutional care may lack.

 

However, further analysis of the survey data indicates that institutional care’s professional medical care (81.2%) and ability to provide round-the-clock support and supervision outweigh the advantages of home care. Additionally, the emotional and physical toll on family caregivers often compromises the quality of home care, as reflected in open-ended responses emphasizing the need for more caregiver support and training. Institutional care addresses these challenges by providing both expert care for the elderly and relief for their families, making it a more sustainable option overall.

 

Another opposing viewpoint is that only 9.4% of respondents explicitly favored institutional care, suggesting that it lacks emotional appeal or social acceptance compared to home care. Open-ended responses also emphasized that institutional care could benefit from more engaging activities and a welcoming environment to attract elderly individuals.

 

Nevertheless, the data reveals that 50% of respondents view both care types as beneficial, indicating a growing acknowledgment of the value institutional care provides. Furthermore, improvements in institutional care settings, such as integrating more personalized services and social activities, could bridge the gap and address these concerns. As respondents noted, institutions already play a vital role in offering relief for family caregivers (79.7%), which is essential in Taiwan’s aging society.

 

Several respondents indicated that Taiwan’s Long-Term Care 2.0 program could be further improved. In addition to the findings of this study, existing literature on Taiwan’s long-term care policies highlights ongoing challenges within the current system. Huang and Yang (2021) emphasize that, despite significant progress under Long-Term Care 2.0, issues such as financial mechanisms, need assessments, and integration with healthcare remain unresolved. Their work underscores the necessity for comprehensive reforms to enhance institutional care and ensure its long-term sustainability for Taiwan’s aging population. This is consistent with the findings of this study, which also emphasizes the need for greater awareness and resource allocation to address these gaps in institutional care.

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V. Conclusion

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This study examines the preferences for elderly care in Taiwan, with a focus on home care and institutional care options. The purpose of this paper is to highlight the potential benefits of institutional care, particularly in light of its professional medical support, 24/7 supervision, and relief for family caregivers. The finding reveals a knowledge gap , with75% of respondents being familiar with home care, while only 64% are familiar with institutional care. This suggests that public perception could be influenced by the level of knowledge about institutional care.

 

To address this, increased efforts to educate the public about the benefits and services provided by institutional care could shift preferences in its favor. Wang (2014) identifies key success factors for institutional care, such as service quality, leadership and management, which are crucial for the successful operation of long-term care facilities in Taiwan. Educating the public about these factors could help alleviate concerns and promote institutional care as a viable option for elderly care. Additionally, policymakers should consider strategies to improve access to institutional care, making it more inclusive and responsive to the diverse needs of Taiwan’s aging population. 

 

VI. References

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Ministry of Health and Welfare. (2022). Yu gu 2025 nian Taiwan mei 5 ge ren zhong you 1 ren shi zhang zhe fang lao hua gu jian shen ti, ji ji bu jian yin fa jian shen ju le bu. Retrieved from https://www.mohw.gov.tw/cp-16-71816-1.html

Miguel, S., Alvira, M., Farré, M., Risco, E., Cabrera, E., & Zabalegui, A. (2016). Quality of life and associated factors in older people with dementia living in long-term institutional care and home care. European Geriatric Medicine, 7(4), 346-351. https://www.sciencedirect.com/science/article/abs/pii/S1878764916000395

Huang, L.-K., Yang, P.-S.(2021/06) Reviewing the History of Taiwan's Long Term Care Policy and Analyzing its Future Challenges - Based On Long-term Care Plan 2.0, 9(2), 212-236 https://www.airitilibrary.com/Article/Detail?DocID=23061790-202106-202107050008-202107050008-212-236

Chao-Jung Wang (2014) Key Successful Factors of Long-Term Care Operation and Management in Nantou County (Master’s thesis, National Chi Nan University).

https://www.airitilibrary.com/Common/Click_DOI?DOI=10.6837%2fNCNU.2014.00164

 

VII. Appendices (Questionnaire)

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Questionnaire https://docs.google.com/forms/d/e/1FAIpQLSfihNBMmu0p-kNqzGQExFX_dpO_X9LJGtlLUqmZxPIHrwO-Rw/viewform