The interface between formal and informal support in advanced old age: A 10-year study

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Armi Franca
Edit Guilley
Christian J. Lalive d´Epinay


The aim of this paper is to investigate the interface between the formal and informal support provided to very old people against a background of increasing need for care and a decreasing number of potential informal caregivers. We used a sample of 323 community-dwelling octogenarians participating in the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) (n=1441 interviews). Descriptive analyses and a multilevel model were used to test whether formal and informal services complemented or substituted one another. The study revealed that the amount of informal services increased significantly as the frequency of formal aid increased, indicating that the two networks were complementary in the majority of the cases. In 21.2% of the cases, the formal network partly substituted the informal network (as an adjustment) and only in 6.4% of the cases did the informal support end after the formal support had increased (radical substitution). The concern that the introduction of formal services may curb the readiness of relatives and friends to provide care is thus unfounded.


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Armi, F., Guilley, E. & Lalive d’Epinay, C. (2007). Entraide et recours aux services [Mutual assistance and use of services]. In C. Lalive d’Epinay & D. Spini (eds.) Les Anniés Fragiles: La Vie Au-delà des Quatre-vingts Ans [The frailty years: life beyond eighty years old](pp. 209–246). Quebec, Canada: Les Presses de l’Universite de Laval.

Broese van Groenou, M. I., Glaser, K., Tomassini, C. & Jacobs, T. (2006). Socio-economic status differences in older people’s use of informal and formal help: A comparison of four European countries. Ageing and Society 26(5): 745–766. [Read this article]


Cantor, M. H. (1979). Neighbours and friends, an overlooked resource in the informal support system. Research on Aging 1(4): 434–463. [Read this article]


Cavalli, S. (2002). Vieillards à Domicile, Vieillards en Pension: Une Comparison [Elders at Home, Elders in a Nursing Home: A Comparison]. Lausanne: Réaltiés Sociales.

Davey, A. & Patsios, D. (1999). Formal and informal community care to older adults: Comparative analysis of the United States and Great Britain. Journal of Family and Economic Issues 20(3): 271–299. [Read this article]


Denton, M. (1997). The linkages between informal and formal care of the elderly. Canadian Journal on Aging/La Revue Canadienne du Vieillissement 16(1): 30–50.

Garant, L. & Bolduc, M. (1990). L’aide par les Proches: Mythes et Réalités [Help from Loved Ones: Myth and Reality]. Quebec: Direction de l’èvaluation, Ministére de la Santé et des Services Sociaux.

Guilley, E., Ghisletta, P., Armi, F., Berchtold, A., Lalive d’Epinay, C., Michel, J.-P., et al. (2008). Dynamics of frailty and ADL-dependence in a five-year longitudinal study of octogenarians. Research on Aging, 30(3): 299–317. [Read this article]


Guilley, E., Pin, S., Spini, D., Lalive d’Epinay, C., Herrmann, F. & Michel, J.-P. (2005). Association between social relationships and survival of Swiss octogenarians. A five-year prospective, population-based study. Aging Clinical and Experimental Research 17(5): 419–425.

Gurung, R. A. R., Taylor, S. E. & Seeman, T. E. (2003). Accounting for changes in social support among married older adults: Insights from the MacArthur studies of successful aging. Psychology and Aging 18(3): 487–496. [Read this article]


Horowitz, A. (1985). Family caregiving to the frail elderly. In M. P. Lawton and G. L. Maddox (Eds.), Annual Review of Gerontology and Geriatrics (pp. 57–71). New York: Springer.

Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. & Jaffee, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association 185(Sep 21): 94–101.

Künemund, H. & Rein, M. (1999). There is more to receiving than needing: Theoretical arguments and empirical explorations of crowding in and crowding out. Ageing and Society 19(1): 99–121.

Lalive d’Epinay, C. & Guilley, E. (2006). Statuts de sante et mondes de vie quotidienne des vieillards [Health statuses and everyday life-worlds of the oldest old]. Swiss Journal of Sociology 32(3): 407–427.

Lalive d’Epinay, C., Bickel, J.-F., Maystre, C. & Vollenwyder, N. (2000). Vieillesses au Fil du Temps. 1979–1994: Line Révolution Tranquille [Old Age Across the Years, 1979–1994: A Quiet Revolution]. Lausanne: Réalités Sociales.

Litwin, H. (2004). Social networks, ethnicity and public home-care utilisation. Ageing and Society 24(6): 921–939. [Read this article]


Logan, J. R. & Spitze, G. (1994). Informal support and the use of formal services by older Americans. Journal of Gerontology: Social Sciences 49(1): S25–S34.

Penning, M. J. (2002). Hydra revisited: Substituting formal for self- and informal in-home care among older adults with disabilities. The Gerontologist 42(1): 4–16. [Read this article]


Raudenbush, S. W. & Bryk, A. S. (2002). Hierarchical Linear Models. Applications and Data Analysis Methods (2nd ed.). Thousand Oaks, CA: Sage.

Raudenbush, S. W., Bryk, A. S., Cheong, Y. F. & Congdon, R. T. Jr. (2004). HLM 6: Hierarchical Linear and Nonlinear Modelling (6th ed.). Lincoln-wood, IL: Scientific Software International.

Snijders, T. A. B. & Bosker, R. J. (1999). Multilevel Analysis. An Introduction to Basic and Advanced Multilevel Modeling. London: Sage.

Sundström, G., Malmberg, B. & Johansson, L. (2006). Balancing family and state care: neither, either or both? The case of Sweden. Ageing and Society 26(5): 767–782. [Read this article]


Tennstedt, S., Harrow, B. & Crawford, S. (1996). Informal care vs. formal services: Changes in patterns of care over time. Journal of Aging and Social Policy 7(3–4): 71–91. [Read this article]


Travis, S. S. (1995). Families and formal networks. In R. Blieszner & V. H. Bedford (eds.) Handbook of Aging and the Family (pp. 459–473). Westport, CT: Greenwood Press.

Vézina, A. & Membrado, M. (2005). Un travail de négociation et de gestion des ressources [A task of negotiating and managing resources]. In S. Clément & J.-P. Lavoie (eds.) Les Enseignements de la France et du Québec [The Lessons to be Drawn from France and Quebec] (pp. 186–243). Bonchamp-Les-Laval: èrés.