Although many studies have been published over the past ten years on informal support of dependent elderly, few, if any, have examined the reticence of their caregivers to use formal support services. Further understanding of this phenomenon is required, for it questions the feasability of preventive measures for this population as well as the relationship between formal and informal support systems, considered optimal by government in their efforts to rationalize today's health care services. This article presents a conceptual framework enabling us to better understand the reasons why caregivers of the elderly seldom use formal support services, and discusses health, social and research implications.

Studies on informal caregiving in institutional settings are rare. The impact on their burden of 197 caregivers' perceptions of their elderly dependents' autonomy was investigated. The results of previous research on caregivers' burden in non-institutional contexts were used to provide an empirical starting point for the research. The results of regression analysis show that help for bathing and concurrent demands have an impact on objective burden, but caregivers' perceptions of their elderly dependents and the social support they receive affect subjective burden.

The paper focuses on intergenerational support relations between grandparents and their grandchildren in Germany, and how they have changed from 1996 to 2002. The paper begins with a brief review of the literature on functional aspects of the grandparent-grandchild relationship, after which the research hypotheses about intergenerational support in the relationship are elaborated. Following a description of the data source, the German Ageing Survey, and its samples and measures, the evidence on the patterns of grandparents' provision and receipt of intergenerational support to and from their grandchildren are presented and compared with parent-child support patterns. The analysis also considers variations by age groups and birth cohorts and changes over time. The main empirical finding is that there was a greater likelihood of financial transfers to grandchildren in 2002 than six years earlier. Nevertheless, the grandparents' relationships with their grandchildren remained imbalanced or asymmetrical, at the older generation's expense. It was found that financial and instrumental support patterns between grandparents and grandchildren were best explained using an ‘intergenerational stake’ hypothesis rather than one of ‘intergenerational solidarity’; the latter is more consistent with parent-child support patterns.