Dimensions of Custodial Care for the Elderly in Bermuda

Physical deterioration affects a significant proportion of the elderly segment of the population. Such deterioration often renders affected individuals unable to transport themselves, do housework, or even perform personal hygiene.

Types of Care and Alternative Venues

The conditions which lead to requirements for custodial care for the elderly may best be described as chronic. Chronic ailments and conditions, in contrast to acute illnesses, cannot be cured. Therefore, persons afflicted with chronic ailments "require sustained supportive health and social services as well as ongoing medical and medically related treatment" (Minahan, 1987, p. 111). Sustained supportive services, and ongoing medical and medically related treatment translates into longterm care (LTC). LTC is defined as:

. . . health, personal care, and social services delivered over a sustained period of time to persons who have lost . . . some capacity for selfcare. LTC may be continuous or intermittent. It strives to provide care in the least restrictive environment (Minahan, 19

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he American population. This nonavailability is typically for reasons of the cost of services, but it is also, at times, associated with location. Public financial support for some hospitals in the United States, thus, is provided because the supply of such services for some elements of the population would not otherwise be available. Custodial services for the elderly in Bermuda are provided as both public and private goods. For the government to assume responsibility for the funding of all such services, regardless of whether or not private institutions continued to deliver the 110services,would convert custodial services for the elderly to a public good in Bermuda. Custodial Services, Public Goods, and the GNP The GNP is the gross domestic product (GDP) plus the income accruing to domestic residents arising from transactions abroad, and less the income earned in the domestic market accruing to foreigners abroad. To a great extent, the GNP is the GDP adjusted for exports and imports; however, investment income is also a significant factor. The GDP is a measure of the total flow of goods and services produced by an economy over a specified time period, excludi
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