Elder-care, assisted living, and nursing homes for aging and needy patients are increasing in number. Moreover, with the increase in the number of children aging at home and patients with dementia or stroke staying at home, various caregivers need to provide such support. However, while a considerable amount of study has been conducted regarding various factors affecting elder care in old-age homes or in nursing homes, there has been few research in the home care industry. Therefore, the purpose of this study is to provide a reference for the development of the home care industry, by analyzing the factors influencing elder care in home-based care. 2. Methods ========== This study was conducted through an on-line survey for the elderly by using computer software. The survey was delivered to elderly clients who were in need of home care and who responded, from 15th June 2008 to 15th December 2008. The participants were those who were at least 50 years old and who had visited the nursing center once or twice within the last three months. Of 1,000 elderly subjects who responded to the survey, there were 1,003 individuals (503 men and 500 women) who required home-care from nursing centers. For statistical analysis, data were analyzed through the SPSS program version 10.0. The statistical program was composed of the descriptive statistics and inferential statistics. The descriptive statistics included mean and standard deviation (S.D.), number of subjects, and frequency ratio. We used chi-square test to examine any significant differences between dependent variables (care receiver's general characteristics and caregiver's general characteristics) and independent variables (caregiver's general characteristics, care receiver's general characteristics, service period, and economic conditions), and utilized logistic regression analysis to test the relationship between the dependent variables and the independent variables. For statistical significance, p-values were verified at 0.05 or lower. This study was conducted in accordance with the Declaration of Helsinki, and with the approval of the Institutional Review Board of Kyungwon University (IRB No.20070828/2008-07-28). 3. Results ========== The average age of the subjects was 69.55, and was 69.54 for men and 69.56 for women, respectively. The subject's life-long average income level was 16.68 million Won (S.D. ±4.89), and the level of education was 11.21 years (S.D. ±4.07) (Table [1](#T1){ref-type="table"}). The number of elders who had received home-care for less than a year was 665 (65.6%), and the number of elders who had received home-care for more than 5 years was 338 (34.4%). This means that, for the study, the length of the service was classified into two categories, i.e., "less than a year" and "more than 5 years". ###### Elder's general characteristics ================= ------------------------------------------ -------------------------------------------- Characteristics Age 69.54 Gender 69.55 Monthly family income (10,000 won) 16.68 (4.89) Education level 11.21 (4.07) Length of service Less than 1 year 33.8% 1\~5 years 66.2% Service type Home care 65.6% Living with spouse 61.3% Care receivers Living with spouse 75.1% Age 74.43 (5.39) Age distribution Male 73.84 (5.33) Female 74.68 (5.33) Nursing-care service type Home care 65.6% Long-term care 14.8% Adult protection 8.3% Long-term care and home care 4.2% Physical disability 0.4% Variables Gender of care-givers Female 67.1% Economy Level of education of care-givers 12.6 (3.8) Factors Level of education of care receivers 12.12 (3.7) Home-based care Monthly household income 17.08 (3.61) Age of care receivers 74.49 (5.29) Service period Less than 1 year 34.4% 1\~5 years 65.6% Service area    Local government 35.8%   Provincial government 20.5%   Private 5.2%   Church 0.7%   Others 37.7% With regard to economic condition, those who had an average monthly income of more than 15 million won were classified as having "high-income", and those with an average monthly income of less than 15 million won were classified as having "low-income". There was a significant difference in age, marital status, and length of service according to economic conditions. As age increased, income level declined (p \< 0.001). The service period was longer (p \< 0.001) and the income level was higher (p \< 0.001) in the high-income group, and the economic condition was also better in the high-income group. The subject's length of service was dependent on the length of service (p \< 0.05), and the care receivers lived together with their spouse in 61.3%. However, there were no significant differences in service period and economic condition depending on the service type. As the age of the care receivers increased, service period became longer (p \< 0.001), and the income level was higher (p \< 0.001). The caregiver's monthly household income was 17.08 million won (S.D. ± 3.61), and the monthly household income was classified as high-income for those with more than 15 million won. Level of education was classified as high-education for those who had a level of education of more than 14 years (Table [1](#T1){ref-type="table"}). In the male subjects, the characteristics of the elderly (care receivers), length of service, and service period were not significant. In the female subjects, however, the characteristics of the elderly, service period, and service type were not significant. The number of home-care workers is on the rise every year. However, there has been a gradual increase in the number of caregivers. Therefore, there is a need for a plan to balance the growing numbers of the elderly and the aging population and to keep the service quality constant. To find out the reason why there is an increasing number of older adults as caregivers, we interviewed some of them. The following are the general characteristics of some of them. • About two-thirds of the subjects had been in the care-giving business for more than 5 years. • The majority of the subjects expected to continue their careers in this line as long as possible. They reported that the caregiver was not well paid and the income level was low. The subjects said that they were motivated to help the older adults due to a sense of responsibility to help take care of the elderly who had stayed at home for a long time. • Because of their age, the subjects did not consider themselves fit to care for the elderly at home. They said that they felt burdened by their social duties and family responsibilities. They also thought that it was because they were not active physically and were weak. • The most common reasons for their careers were to take care of aging parents, spouses, and elderly children. • About two-thirds of the subjects experienced depression after a long service period. They felt that they had not been able to make the important decision of changing their own life and could not cope with their problems. • The subjects did not expect many rewards for their work, which was mainly out of a sense of duty to help take care of older adults. However, the subjects were disappointed and worried that they could not repay for the work of helping others. • About three-fourths of the subjects perceived that they received help from their families and friends. However, some of the subjects complained about a sense of resentment towards their family members or friends. They had a feeling that the family should have given more help to them in the home environment. However, they thought that they had a bigger responsibility to the family than they did before. • Most of the subjects recognized that taking care of a caregiver depended on the caregiver. It was a joint effort between the caregiver and the client. They felt depressed when a caregiver had a problem at home, which disturbed the entire family structure. • Many of them felt that their role as caregivers was not fully recognized and respected by the public. They stated that they felt guilty because they had to take care of their parents, spouse, or children at home. 4. Discussion ============= Factors