Research Programme

Understanding pathways into institutional care

Jane Falkingham, Maria Evandrou, Athina Vlachantoni, Olga Maslovskaya

Project summary


This project aimed to assess the usefulness of the British Household Panel Survey (BHPS) for the study of pathways into institutional care in later life, and to explore the factors associated with the transition of older people into two kinds of accommodation: residential care and sheltered accommodation. This study has built on existing research in order to conceptualise moves into residential care or sheltered accommodation as being affected by a wide range of factors such as the demographic, health and socio-economic characteristics of the older person, as well as policy-related factors which include the receipt of support from the state.


This project employed all 18 waves of the BHPS (1991-2008), drawing on the older population in the sample (aged 65 and over). Two outcome variables were used for the analysis. The first referred to a person’s transition into an institution, and the second referred to a person’s transition into sheltered accommodation. The explanatory variables included indicators of a wide range of factors, and were grouped into five categories: demographic characteristics; health status; the use of formal care services; socio-economic and financial characteristics; and informal care receipt.

Exploratory analysis was conducted in order to investigate the relationship between the response variables and explanatory variables. Bivariate associations were made between the outcome and explanatory variables. A discrete-time binary logistic regression with manual forward selection was used in order to model the probability of entering sheltered accommodation and residential care, and to identify the factors which are associated with such transitions.


The findings of this study have implications both for the design of social care provision for older people and for the quality of life of older people towards the latter part of their lives.It showed that transitions into residential care and sheltered accommodation are associated with a diverse range of factors, including demographic and socio-economic factors.

In terms of older people’s move into residential care, the results suggest that people aged 80 and over, women, single or widowed, people in the poorest quintile and people who have no children or one child, are the most likely to move into residential care.

The multivariate analysis showed that age, health and marital status were the factors most strongly associated with a person’s move into residential care. By contrast, the move into sheltered accommodation was associated more strongly with a person’s socio-economic situation than their health status.

The study highlighted age and marital status as key characteristics concerning a person’s move into sheltered accommodation, and showed that housing tenure, a person’s highest educational qualifications and receiving informal care were the factors most strongly associated with a person’s move into such accommodation.


Project activities

Date Activity Description
13-16 June 2012 Presentation at the Europe Population Conference 2012 held in Stockholm, Sweden.  The paper ' Transitions into sheltered accommodation and residential care in later life: evidence from the British household panel survey (1991-2008)' written by Maria Evandrou, Jane Falkingham, Olga Maslovskaya and Athina Vlachantoni was presented at this event.



Vlachantoni, A., Maslovskaya, O., Evandrou, M. and Falkingham, J. (2016) The determinants of transitions into sheltered accommodation in later life in England and Wales. Journal of Epidemiology and Community Health (Online first view).

Vlachantoni, A., Shaw, R., Willis, R., Evandrou, M., Falkingham, J. and Luff. R. (2011) ‘Measuring the unmet need for social care amongst older peoplePopulation Trends, 145,  60-76.


Media activities

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