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The US model of long-term care for the elderly and disabled assumes that institutions are preferable, but family members, especially women, provide most of the care. However, as the number of elderly increases, life spans lengthen and women become less available to provide at home care due to employment, their own health status as elderly spouses and other reasons, new plans must be made. Government and corporate programs are increasingly insufficient to pay the costs of institutional care. Individuals must be given more choice, more training and more support in their role as caregivers.