As the population ages, there will be an increased need for long-term care for the frail elderly. The families of the elderly not only play a highly significant role by providing most of the needed care, they also make most of the long-term care decisions.

Janis and Mann (1977) postulate that during the decision process itself, antecedent conditions "predispose" decision-makers towards the outcome which will reduce the chance of loss to themselves or significant others. This predisposition also limits the information sought and processed and, therefore, the decision itself. When loss cannot be totally avoided, a "good enough" solution will be found, but this will cause decision conflict and stress.

Sixteen (16) characteristics of the decision-makers, the elderly, and the decision situation have been associated in the literature with long-term care outcomes (home care-taking or nursing home care). This study tested the strength of association of these characteristics with the long-term care choice. It also examined conflict in decision-making.

Data was reported by Social Workers in four teaching hospitals. Eighty-one cases were included: 43 home care and 38 nursing home care. For thirteen characteristics no support for the literature was found. Three were significantly associated with outcome: family support for the decision, physical condition (continence and mobility) and assimilation of the elderly person. Different characteristics were associated with conflict in decision-making.

A Discriminant Analysis showed that physical condition and assimilation"predicted" over 74% of the cases and explained 67% of the variance in the discriminant space. Home care patients were found to be in fair condition and unassimilated and nursing home patients in poor condition and assimilated.

Recommendations to Social Workers for more appropriate intervention were made as were recommendations to hospitals, Social Work Departments, and Life-Care Communities. It was further recommended that this study be replicated with a larger number of cases so that long-term care preference and conflict in decision-making could be explored fully. Implications for cost-containment, policy formation, and ease of decision-making were also discussed.