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William F. Forbes, Jennifer A. Jackson and Arthur S. Kraus, Institutionalization of the Elderly in Canada , Butterworths, Toronto and Vancouver, 1987, 148 pp., Can $15.95, ISBN 0 409 80522 X.

This monograph presents the currently available information on the organization, use and users of long-term care for the elderly in Canada. It also includes chapters on the community-institutional interface and on specific preventive and therapeutic programs for institutional residents. The concluding chapters focus on concerns about long-term facility care and on future directions for policy and research. The authors faced formidable challenges in achieving their goal. The original federal-provincial cost-sharing agreement, on which the Canadian Health Insurance Plan is based, applied only to hospital and medical services. This agreement included a commitment by the provinces to submit specific data on the distribution and use of these services. No such agreement was ever concluded for community or long-term institutional care. These programmes remain exclusively within provincial jurisdiction. One result is that Canada has as many different policies, programmes, terminologies and information systems as there are provinces. Another result is that the provinces are reluctant to supply the federal government with data, leaving Statistics Canada to gather information from other sources, e.g. service providers, without its having adequate knowledge about the nature of what it is counting. Consequently, reliable data are hard to find and even harder to interpret.