Life expectancy is increasing in many parts of the world. Not only are more people living to old age, but more are also being enabled to live with disabling conditions that once might have been fatal. People who are chronically ill, those with serious disabilities, people with HIV/AIDS, mentally ill individuals, the victims of accidents and disasters, the elderly--many of these, and others, need continuing care and support. As the number of people in need of long-term care continues to grow worldwide, consideration of the best way to meet this need is receiving much more focus. The aim of such care is not simply to look after the sick but to enable those with long-term illnesses or disabilities to live their lives as fully and as rewardingly as possible. Such care is not just a social responsibility; it is a vital element in development. Institutionalization is often not the most suitable form of long-term care. The home, where the patient lives with family members, and where friends and other members of the community are not far away, is frequently more appropriate. This report by an international WHO Study Group examines the options. It points clearly to the benefits that home-based care offers to the patient, while stressing that the personal and health needs of caregivers in the home must not be compromised. Home-based long -term care has been practised by families for centuries, and family members will always remain a valuable resource for care. This report argues that it is time for health systems to take responsibility for providing caregivers in families and communities with the support they need both to help make their tasks more bearable and to bring a greater share of benefit to the patient.