This study examined the needs of elderly, disabled elderly people, and their non-professional carers in terms of information that enables access to support that can help make life easier at home. This was done using:

· a survey of the literature on the characteristics and information needs of the current generation of elderly people as a whole;

· a limited study on enquiries made by elderly people to formal information and advice providers;

· focus group investigations of elderly, disabled elderly people and their carers;

· an extensive questionnaire survey, designed according to the information gathered using the three methods above, targeting three groups: disabled elderly people attending Day Care Centres; less frail elderly people attending Social Clubs; carers of disabled elderly people attending carers' support groups.

In this part of the report, the findings are discussed and overall conclusions drawn. Firstly, a number of methodological issues were identified in carrying out this research and three issues that are particularly important in relation to this study are addressed in Chapter 2. These are: how representative the questionnaire survey results were; the performance of elderly and disabled elderly people participating in needs research; and levels of acceptability for people experiencing difficulties.

Secondly, in Chapter 3, the results that emerged and conclusions that were drawn are examined. The study set out to answer four questions:

1. What support and information do elderly, disabled elderly people, and their carers have?

2. What further support do they want to make life easier at home?

3. What information do they need to give them access to this support?

4. How would they prefer to get this information?

The answers to these four questions are considered in the light of the results and conclusions of the study on enquiries to information providing organisations, the focus group investigation, and the questionnaire survey. Whether the results are useful in answering each question and how they relate to the findings of previous research in the area is discussed. Where problems and needs are indicated for the groups of interest, practical solutions or further possible research is suggested.

Finally, overall conclusions are drawn, in terms of the implications for the provision of support and information to elderly, disabled elderly people, and their carers and the implications for future research.

2 Methodological issues

2.1 Representation

For the questionnaire survey, disabled elderly people, less frail elderly people, and carers of disabled elderly people were sampled from three specific groups: Day Care Centre clients; Social Club members; and members of carers' support groups, respectively. Restricting the samples to these three groups is not an ideal sampling method. Therefore, in interpreting the questionnaire survey results, it cannot be assumed that the results necessarily represent the needs and problems of elderly people in the UK as a whole. However, the results are likely to be indicative of the needs and problems of the three populations of interest, for the following reasons:

· the large numbers of respondents, particularly in the Day Care Centre and Social Club groups;

· good consistency of questionnaire answers between the three groups targeted;

· good agreement of the questionnaire survey results with information gathered by other methods;

· good agreement of the results of this study with previous research on the information needs of elderly people as a whole.

2.2 Performance of elderly and disabled elderly people

The literature survey identified a number of age-related declines in various sensory, perceptual and cognitive abilities. These declines in ability can affect the performance of elderly people in tasks requiring: perception, comprehension and memory of spoken or written information; communication; attention; and information processing. This has important implications for research into the needs of elderly people using questioning techniques such as interviews, focus group discussions and questionnaires. Although age-related declines in ability and associated performance are well documented in gerontology literature, studies into the information needs of elderly people do not report any difficulties with questioning elderly people.

The traditional method in sociological or needs research for finding out how people think or feel about something is to ask them, in individual or group interviews, focus group discussions or questionnaires. A postal questionnaire survey, carefully designed using information gathered in focus groups, has the advantages of being a cheap, convenient, and effective method for gathering information on a large number of widely dispersed people. Focus groups enable a large amount of information to be gathered on a topic in a limited period of time (Morgan, 1997) and, as in this study, can be low cost. These methods, however, are generally used only to provide a single snapshot in time of a situation. Their use in longitudinal studies is more costly and time consuming.

Problems encountered in running the focus groups in this study, particularly with disabled elderly people, were consistent with the age-related declines in performance described in the literature. Furthermore, in the questionnaire survey, a small number of questionnaires were incorrectly filled in, despite pilot testing, apparently due to respondents not reading or understanding the instructions. However, such problems can occur with questionnaire respondents of any age. Over a half of the disabled elderly Day Care Centre clients needed help from a member of staff to complete their questionnaires. For the majority of these people the reason they could not complete the questionnaire by themselves was due to disability. Day Care Centre staff were instructed to provide help with filling in questionnaires, if needed, and to ensure that they gave the recipient's answers, not their own interpretation. However, it is important to note that it is not known to what extent the helper used their own judgement of their client's needs and difficulties in answering the questions.

Age-related performance deficits and communication difficulties need to be taken into account in any well-constructed approach to studying the needs of elderly people, particularly those with disabilities. If the disabilities prevent the elderly people from being able to answer questions by speaking or writing, then someone is needed to answer, either fully or partially, on their behalf. However, there are dangers associated with trusting someone else to act as another's "voice". For example, there is the question of who is the best person to act in such a way: a family member, the non-professional carer, or the professional care worker? A family member who lives with and cares for the disabled elderly person may be closest, but is also likely to be elderly and frail.

Can researchers rely on the responses given by disabled elderly people, or other people on their behalf? In particular, can the responses of those with cognitive impairment be considered valid? It may be more appropriate to use behavioural observation to ascertain the needs and problems of disabled elderly people and their carers. This would be most effective if carried out over some period of time, with continuous monitoring of the lives of a number of disabled elderly people and their carers. Observational studies in a field setting, compared to focus groups, have the advantages of taking place in a more natural environment and enabling behaviours to be followed in-depth over time. Nevertheless, as with all research, there exists the problem of investigator effects. In this case, even with minimal interaction, the mere presence of an observer could influence a participant's behaviour. As a technique for collecting data, continuous long-term behavioural observation is costly compared to longitudinal studies employing interviews, focus groups, or questionnaire surveys to gather frequent snapshots of a situation.

Close long-term observation of this nature raises particular ethical issues beyond those usually associated with research with humans, mainly due to the intimate daily contact between the researcher and the participant and the strong bonds that can develop between them. In addition, ethical problems are intensified for research with elderly, disabled elderly people and their carers, due to the vulnerability of these populations. For example, a common ethical issue is that of ensuring informed voluntary consent. Kayser-Jones and Koenig (1994) point out that, in participant observation, informed consent is obtained formally when first entering into the field, then in an informal way on an almost daily basis. The researcher has to constantly re-explain his or her presence and activities and create a meaningful social bond with the participant. In qualitative research building a rapport facilitates data collection and intimacy is traditionally seen as increasing the validity and richness of the data (Pearsall, 1965). However, for an elderly participant the bond that has developed can make withdrawal from the study difficult (Kayser-Jones and Koenig, 1994).

The intimate daily contact and strong bonds that can develop can also cause difficulties for the researcher observing the elderly person. Kayser-Jones and Koenig (1994) suggest that perhaps the greatest ethical dilemma for the researcher carrying out observation of an elderly participant happens when the participant needs help. Whether to intervene in such a situation is a difficult decision, particularly for a researcher who has spent many long hours with a participant and has become close to him or her. Kayser-Jones and Koenig (1994) found that, in the literature, opinions are divided on this issue. Some researchers believe that intervention must be avoided because it contaminates the data and makes the research invalid. Others feel that ethical obligations dictate that the researcher must occasionally intervene (see Kayser-Jones and Koenig, 1994). The use of technology to collect observational data remotely could reduce, although not eliminate, ethical problems. In addition, the data collected would be free of the influence of the researcher. Such techniques, however, can be particularly costly.

2.3 Levels of acceptability

One methodological issue that is repeatedly raised throughout the report is that of setting the acceptable percentage of people experiencing difficulties with everyday tasks and with accessing the information and support they need. In ergonomics, products and tasks are evaluated and designed according to the criterion that a large percentage of the population (at least 90%) should be able to use a product or carry out a task effectively, easily and safely. People with deteriorating ability are accommodated. In some situations part of the population has to be excluded for safety reasons. For example, the lids on medicine bottle are designed so that small children cannot open them easily, which means that people with weak hands also have difficulty opening them. It has to be accepted that there will come a point when people with deteriorating ability will cease to be able to perform certain things easily by themselves and will require increasing amounts of help from others or from special devices, even with the most routine of tasks. The point at which this occurs depends on factors such as age, type of disability and environment. This needs to be taken into account when considering the issue of the acceptable proportion of people experiencing problems.

With elderly people it is not possible to ensure that everyone in the population can manage easily without help. In reality, the acceptable percentage of people experiencing difficulties cannot be set at a particular level because it will vary with age, the existence of any disabilities, and the type and degree of disability. However, in this study, for practical purposes and to enable a decision to be made on whether action needs to be taken, this study has used a level of 10 per cent (a tenth) or more of people as a general criterion level of acceptability. As the percentage of people having difficulties with everyday tasks and getting the support and information they need rises above the 10 per cent level, the more unacceptable the situation becomes and the more imperative the need for remedial action becomes. It is worth noting that levels of acceptability may well change for future generations due to changing levels of expectation, in that people may become less prepared to tolerate difficulties with daily living, and technological and medical advancement.

3 Results and conclusions of the study

3.1 What support and information do elderly, disabled elderly people, and their carers have?

In answering this question, support and information are examined separately. The questionnaires provided information on whether the groups investigated had enough support and information for their needs and the types of information they possessed. From this, conclusions are drawn on whether more support and information are needed and from whom.

Support

The questionnaire survey provided information on whether the amount of support received, in terms of practical help, was sufficient to meet the needs of the groups of interest. This showed that around a quarter of the elderly Day Care Centre clients and Social Club members did not get enough practical help with those everyday tasks that they were unable to carry out by themselves. Carers of elderly people demonstrated even greater need for more practical help, with over half of the survey respondents being dissatisfied with the amount of help they received. Carers in the focus group also expressed dissatisfaction with the amount of support that they received in terms of practical help and services, in that initial good support seemed to dry up as time passed. Thus, unacceptable proportions of the groups surveyed needed more practical help with routine tasks.

In terms of formal support from social services for elderly people living at home, the literature survey found a trend towards more intensive help for the most needy. The result seemed to be that fewer people received the less intensive 'domestic' help. This is wholly unacceptable, given the level of unmet need for practical support found in the questionnaire survey and the associated implications for quality of life and sense of well-being.

The survey indicated that, as would be expected for the groups targeted, that disabled elderly people and their carers received most help with routine tasks from Social Services and the family doctor, and more help overall than the less frail elderly people in social clubs. However, a large proportion of all respondents was not satisfied with the help they got. Around one third of each group surveyed did not easily get all the help they wanted. Thus, unacceptable proportions of disabled elderly people, their carers, and less frail elderly people were dissatisfied with the support they got, in particular from the health and social services, in terms of practical day-to-day help.

This does not provide a full picture of the support that the three elderly groups of interest have, but focuses on support in terms of practical day-to-day help. Other forms of support such as health care, counselling and emotional support did not emerge as major needs in the focus group investigation, so were not examined in the questionnaires. From the information presented above, it can be concluded that there is a need for increased provision of practical help at home by Social Services and charitable organisations to these groups. There is also a need for easier access to such help.

Information

The three groups of interest did not possess sufficient information for their needs. The questionnaire survey found that around a third of the Day Care Centre and Social Club respondents and over half of the carers said that they had needed help and did not know whom to contact to get it. Carers, therefore, demonstrated the greatest need for information. But, for all three groups, there is an unacceptable level of unmet need for information on appropriate sources of support.

The literature survey and results of the focus group investigation found that elderly people in general lacked awareness of the various types of support available to them and the vast amount of information on such support. The questionnaire survey examined awareness of information and advice providers. Carers showed the highest level of awareness, followed by Social Club members, then Day Care Centre clients. However, awareness was unacceptably poor among all respondents. Age Concern was the only organisation for which the level of awareness rose above the minimum acceptable level of 90 per cent of people in all three groups.

Further research is needed to determine why the level of awareness of sources of support and information is unacceptably poor among these groups of people. Further questions that need to be asked and investigated are:

· What are formal information providers and support services doing to target elderly people and make them aware of their existence?

· Why is Age Concern so well known compared to other formal information providers for elderly people? Is it due to the prominence of local Age Concern Centres, transport services for elderly people, and charity shops?

· How can formal information and support providers improve awareness of their existence and the services they provide among disabled elderly people, their carers, and less frail elderly people? Collaboration between providers may be the key, and this is discussed further in Chapter 5 of this part (Part 7) of the report.

The questionnaire survey results also enabled identification of the areas of information in which the respondents possessed most knowledge. All three groups were most knowledgeable about where to get help on pensions. Overall, carers were slightly more knowledgeable than the other two groups. However, for every information area investigated, the level of knowledge among all respondents was below the minimum acceptable level of 90 per cent of people. Thus, given a specific information need, the respondents showed an unacceptable lack of awareness of the appropriate source for that information.

Health and Social Services staff in regular contact with disabled elderly people, social clubs for elderly people, and carers' support groups are potentially the most accessible formal sources of information for elderly people and their carers. However, previous research, the focus group investigation, and the questionnaire survey concur. In general, these people and groups are not fulfilling their potential as key information providers to the elderly people they are in contact with. To make access to information easier for elderly, disabled elderly people, and their carers, information provision by those in close and regular contact with these groups should be much improved.

3.2 What further support do they want to make life easier at home?

The focus group investigation and questionnaire survey provided results that enable this question to be answered with reference to support in terms of practical help with day-to-day tasks.

The results of the focus group investigation and questionnaire survey indicated that for disabled elderly people, their carers, and less frail elderly people, similar types of day-to-day tasks caused the most widespread difficulties. These tasks were those that made most demands on peoples' physical strength and endurance, particularly those related to indoor and outdoor mobility. Thus, to make life at home easier for the groups studied, practical help should focus on these types of tasks, particularly those that caused the most severe difficulties:

· getting around outdoors, for Day Care Centre clients;

· taking a bath, for Social Club Members;

· helping the person they care for to use public transport, for Carers.

In addition, although those experiencing difficulties with visual tasks were relatively few, for these people such difficulties were the most severe.

The difficulties experienced have significant implications for quality of life and feelings of well-being. Therefore, it is important to note that, for Day Care Centre clients and carers, very few tasks examined in the survey fell below the 10 per cent minimum acceptable criterion level for percentage of people experiencing difficulties. Ideally, then, for these groups, help should be readily available and easily accessible when needed for almost all of the tasks examined. For Social club members around half of the tasks met the criterion level of acceptability.

The need for more and better support in terms of practical help is evident from the questionnaire survey finding that unacceptable proportions of all three groups needed more help with things that they were unable to do and expressed dissatisfaction with help they did receive (see Section 3.1, above)

3.3 What information do they need to give them access to this support?

In answering this question the first consideration is whether elderly, disabled elderly people, and their carers actually have information needs. It clear from the results presented in answering the previous questions (in Sections 3.1 and 3.2, above) that these groups do have unmet information needs. Unacceptable percentages of the people surveyed experienced difficulties with routine tasks and were unaware of how to get the information and practical help they needed. Thus, the survey results indicate a need for more information on:

· practical help available with day-to-day tasks, particularly those that are most physically demanding and involve mobility;

· appropriate contacts for practical support, information and advice.

A closer examination of the areas of information need was made indirectly in the study on enquires to formal information and advice providers for elderly and disabled people, and directly in the questionnaire survey. Drawing together the results of these two parts of the study, and those of the focus group investigation and literature survey, allows conclusions to be made about needs for information that enables access to support at home. It can thus be concluded that elderly, disabled elderly people, and their carers have substantial information needs in the following areas:

a. financial help they are entitled to;

b. practical help, support and services at home;

c. housing, home adaptations and products to help make life easier at home.

The focus group participants and questionnaire respondents also wanted to know:

d. whom to contact on all these matters;

e. local contacts for information on all these matters.

There is a large amount of information and advice currently available on the topics listed in points a, b and c, above. This information is provided by numerous formal sources, through various channels of communication. However, it has been shown that unacceptable proportions of the groups of interest are unaware of the various information providers available to them and the appropriate provider to contact for specific information.

Tinker et al. (1993) concluded that formal information and advice providers play an important role in information provision to elderly people as a whole. This conclusion was based on various factors such as: the volume of enquiries; the number of people asking for help for the first time and demonstrating considerable need; and the relatively small number of people receiving help compared to the potential numbers that could need help. The present study indicates that organisations specialising in providing information and advice to elderly people are still an important source of information, due to the large number of enquiries made to Age Concern England, Help the Aged and Counsel and Care. Such organisations receive large volumes of enquiries and yet there still exists an unacceptable level of unmet need among the groups investigated in areas of information such as financial and practical help available. In meeting this need, the priority for formal information and advice providers must be to heighten their profile among disabled elderly people, their carers, and less frail elderly people. As recommended in Section 3.1 in this part of the report, further research is needed to determine why these groups of elderly people have this unacceptably poor level of awareness of formal information providers and what the providers can do to improve this awareness.

3.4 How would they prefer to get this information?

Evidence from the literature survey suggested that, for elderly people seeking information and advice, face-to-face contact is important. This was also found in the focus group investigation, for elderly and disabled elderly people and, in particular, carers for whom personal contact with other carers was an important means of getting information. For all three groups of respondents in the questionnaire survey face-to-face contact was the preferred means of getting information. Therefore, for a system of information provision to be acceptable to the current generation of over 60s, it would need to involve access by direct contact with other people.

The findings of the literature survey, focus group work and questionnaire survey suggest that a printed publication is not the most appropriate means of communicating information and advice to elderly, disabled elderly people, and their carers. Such a publication would be of more use if aimed at, and distributed to, those people who are in a position to provide face-to-face information and advice to these groups of elderly people. Such people could include Day Care Centre staff, GPs, social club leaders, home care workers, home helps, social workers, health visitors, district nurses, and carers' centre staff.

One unexpected finding of the questionnaire survey was that, for all three groups of respondents, the most preferred term for referring to an elderly person was "senior citizen". This may come as a surprise to providers of information, advice and support to elderly people and their carers. Such organisations favour the use of more modern terms such as "older person" or "third ager", whereas the current generations of disabled elderly people, their carers and less frail elderly people prefer a more traditional, respectful term.

The Internet is a vast source of up-to-date worldwide information and advice and can act as a means of social interaction for elderly people who are isolated and have restricted mobility. There is a very large number of web sites devoted to information and advice for elderly and disabled people. Elderly people in this country run the risk of being excluded from the new information society and from having access to important sources of information, advice, communication and help. The Internet can also be an efficient means of information exchange for carers. The questionnaire survey showed that the Internet is the most disliked means of getting information for the three groups surveyed. The reason could be that they simply have not had the opportunity to learn and use the Internet. Certainly an extremely small percentage of survey respondents used the Internet. Evidence from the U.S. shows that, while elderly people currently use the Internet far less than younger age groups (see Part 2, Section 8.10), theirs is the group that shows the greatest growth in use over recent years. It may well be that, for future generations of elderly people, interaction with other people may not be the most acceptable means of obtaining information.

3.5 Summary of the study conclusions

The information needs of carers have been neglected in research and disabled people have not been studied as a group distinct from elderly people as a whole. The questionnaire survey examined the support and information needs of three groups of elderly people: disabled elderly people attending Day Care Centres; the carers of disabled elderly people, belonging to carers' support groups, who also tend to be elderly themselves; and less frail elderly people attending social clubs. One might expect these groups to have disparate needs, however, in general, there was a good consistency of responses between the three groups. There was also good general agreement among the information gathered using different methods, including previous research on the information needs of elderly people as a whole.

The findings of this study indicate that elderly, disabled elderly people, and their carers have serious problems in terms of getting the support and information they need. To sum up, the current generations of these groups of people need:

· more and better practical support with everyday tasks;

· practical support that is more easily accessible when needed;

· information on the financial help, practical help, housing, products and home adaptations, support and services at home that are available to them;

· correct and up-to-date information on the appropriate sources for support, practical help, information and advice, given a particular need;

· information that is more easily accessible via face-to-face contact with other people on a local basis.

The following Chapters discuss the implications of the findings for the provision of support and information to the groups of interest and for future research.

4 Implications for formal support and information provision

The results of this study have important implications for formal sources of support that provide practical help at home to elderly, disabled elderly people, and their carers. To meet their needs, statutory (Social and Health Services) and voluntary (charitable organisations) support providers need to:

· provide increased practical support with everyday tasks;

· make the practical support more easily accessible;

· increase awareness of their existence and the types of support they provide through cooperation with information providers.

There are also implications for sources of information and advice. Organisations that produce and provide information for elderly people and their carers need to:

· increase awareness of their existence and the information they provide;

· increase awareness of the appropriate sources of information, advice and practical support, to satisfy a particular need;

· make information more easily accessible by:

- making it available at locations where elderly, disabled elderly people, and their carers regularly go, e.g. Day Care Centres, GPs surgeries, social clubs for elderly people, carers' support centres;

- communicating the information by the most preferred means (face-to-face contact), using those people who are in close and regular contact with the populations of interest.

· ensure the information is relevant to the needs of particular groups within the elderly population.

4.1 Improving information quality, awareness and ease of access

This study identified several topics in which the groups of interest had substantial information needs. This information is widely available, in varying quality, from numerous sources, via different channels of communication such as printed material, telephone help lines and the Internet. There is currently a great waste of resources due to duplication of effort in information provision. Better coordination among information providers should avoid unnecessary replication of information.

Information producers and providers are improving the quality of information for elderly people, for example by using large print, clear structure and layout, and simple language. However, there is little point in producing good quality, useable information if an unacceptable proportion of elderly people do not know that it exists or where and how they could get it. The primary need is, not for more or better quality information, but to increase awareness of appropriate providers and to improve ease of physical access.

Once the problems with awareness and ease of physical access have been solved, providers need to ensure that the information for particular groups within the elderly population is well directed in terms of content and presentation. To be of use information needs to be well targeted, appropriately timed, relevant to the needs of the elderly groups of interest, accessible with respect to the way it is written, and useable. There is a requirement for close cooperation among information providers. Increased cooperation will reduce replication of information and, hence, costs. Sharing of knowledge and research findings on the needs of elderly people will aid in the production and provision of information commensurate with the needs of these populations. Appropriate research methods are discussed in the next Chapter.

4.2 Delivering information using acceptable channels

Establishing a comprehensive and new system of information provision with a means of access (face-to-face interaction) that is favourable to the current generation of elderly people is not necessarily the solution. An alternative is to make use of the existing support systems. It is then essential that information providers have the help of support providers in delivering the information. If support workers who are in close and regular contact with elderly people are provided with appropriately targeted, up-to-date information they could act as acceptable channels for communication and accessing the information. These channels could include Health and Social Services staff and voluntary workers such as GPs, district nurses, health visitors, home care workers, home helps, social workers, occupational therapists, Day Care Centre staff, social club leaders, and carers' centre staff.

For future generations of elderly people medical and technological advances mean that their information and support needs are likely to be very different to those of the present generation. For example, current trends suggest that future older generations will have very different attitudes towards information technology and using the Internet as a source of information and advice. It is, however, difficult to predict how rapidly this change will occur as it is so dependent on any advances that are made.

5 Implications for future research

5.1 Increasing awareness of support and information providers

This study identified awareness of appropriate providers of information and practical support, given a specific need, as a crucial factor to effective provision for elderly, disabled elderly people and their carers. It is therefore vital to investigate how such providers can increase awareness, among these groups of people, of their existence and the services they offer. This will be more fruitful if carried out by several research organisations, sharing existing knowledge and collaborating. This study found that some information providers were better known than others. It is vital that the reasons for this variation are ascertained, and effective methods of maintaining and increasing an organisation's profile are shared with other similar organisations.

5.2 Ensuring information and support meet the needs of elderly people

To ensure that the information and support they deliver is relevant and useful to particular groups of elderly people the providers need to be constantly aware of current needs. Investigations that obtain infrequent snap-shots of a situation at a particular point in time are not sufficient to get a full picture of the needs of elderly people. It is necessary to carry out frequent (possibly continuous) monitoring, using behavioural observation in the field as well as questioning techniques, as was discussed in Section 2.2 in this part of the report. The cost and organisation of such research can only be satisfactorily met by close and effective collaboration among and between information and support providers.

As discussed in Section 2.2 in this part of the report, behavioural observation in a field setting can at least partially overcome the uncertainty over the validity of answers made by people, or by others on their behalf, in interviews, focus groups or questionnaires. However, frequent or continuous passive observation of people may not provide all the information needed. It may also be necessary to carry out active experimentation by creating situations where there is an information need in a field setting and examining their effect on the elderly people being observed. For example, the researcher could ask the elderly person to find out if he or she is entitled to a particular benefit and observe how the participant goes about this. Just as passive observational studies of elderly participants create special ethical problems for the researchers, giving the participants tasks and observing the outcomes could be even more ethically treacherous. Participants could not be put into a situation where they are forced to do something that may cause them danger, discomfort or distress.

5.3 Evaluation of effectiveness

Any actions taken to improve awareness of appropriate providers of information and support and ease of access to information and practical support, should be evaluated to ensure that elderly people, disabled elderly people and their carers:

a. become more aware of the formal providers of information and practical support and of the appropriate provider to contact, given a specific need;

b. find it easier to get the information and support they want.

In addition, if these groups of people are successfully provided with easier access to the necessary information, via a means that is acceptable to them, it needs to be established that they actually use the information. It would be useful to know the extent to which successful delivery of appropriate information to those with specific needs for practical support actually increases access to the appropriate support service. In addition, if elderly people are offered increased practical support at home, that is more easily accessible when needed, it needs to be established that the support actually alleviates the day-to-day problems experienced.

6 Information provision in the future

The current trend is towards elderly people, and their families, having greater responsibility for seeking information and advice about practical, financial and other forms of support they may need to maintain independence and manage more easily at home. The literature survey showed that being able to stay in their own homes was a fundamental concern for elderly people and the ability to perform everyday tasks and keep a well-maintained house were vital to a sense of well-being, satisfaction with life and feeling part of society (Bowling et al., 1997; Clark et al., 1998). This study has shown that there is an unacceptable shortfall in the number of people within the groups examined getting the practical support that they need, and the information that enables access to this support, compared to the number that actually need help. Furthermore, the growing population of elderly people in the UK means that the demand on providers for sufficient information and support will increase in the future. The rate of increase in the elderly population is expected to rise more steeply as the post second world war "baby boom" generation enters retirement age in the near future (Office for National Statistics, 1998).

In the future, the Internet may become more widely accepted and accessible, not just to young and middle-age adults or those with good educational backgrounds, and may be the information provider of choice. It is difficult to predict how far in the future this may occur. Technological advancement is occurring so rapidly that new techniques for accessing information on the Internet, such as via mobile phones and television, will soon provide an alternative to computer based access.

Nevertheless, this study shows that an unacceptable proportion of the current generations of elderly, disabled elderly people, and their carers do want to electronically access the information they need. The likely reason being that they do not know how to do so. For these groups of people the Internet can be a solution to their information needs only if:

· their familiarity with computers and the Internet is increased;

· Web sites are designed in a way that takes into account the changes in ability that occur with age;

· and the information provided is commensurate with their needs.