"Why Independent Elderly Prefer to Continue Living in Their Home Even When They Become Frail?"

Frail old people have three options for care (informal, formal, mixed): move in with one of their family members (usually one of their children); live in a nursing home or in assisted living setting; continue to live in their home and receive private care or care services (based on the Long-Term Care (LTC) Insurance Law).

As a multicultural society, Israel serves as a natural laboratory for identifying similarities and differences between various groups. The present research compared independent Jews and Arabs aged 65+ who live in the community, on various aspects of their preferences for care.

The study included two stages, a quantitative one, in which closed-ended questions were administered to 200 old Jews and Arabs, followed by a qualitative one, in-depth interviewing 20 respondents. The study found that Jews mostly preferred nursing or sheltered homes, whereas Arabs preferred mostly to remain in their homes. However, approximately 40% of both populations preferred "mixed care," staying in their home with a live-in worker or with one of their children.

Three main aspects were identified: a macro-level aspect of social and cultural context (collectivism vs. individualism); a mezzo level aspect of family patterns and norms (reciprocity and exchange in intergenerational relations); and a micro-level aspect of personal attributes and values (psychological meaning of family/ home; dignity vs. honor). Although main aspects were in general similar between Jewish and Arab respondents, the initial meanings of these aspects were different, reflecting  social contexts, past experiences, family norms and  the importance of home in late life.

Results revealed the need for developing culturally sensitive and tailored programs and services that take into account these aspects. Providing such services would allow old people to continue living in their homes, even when they become frail and need care and support.