Social and demographic trends in Ireland pose the need to develop our system of care for the elderly at home. Currently informal care is the principal source of care for dependent elderly people with institutional care acting as the main alternative, particularly when levels of dependency are high or where informal caring relationships break down or are not possible. Although the past two decades have witnessed the growth of formal community care services for the elderly there is still considerable scope for extending and refining these services and, in particular, for making them more relevant to heavily burdened informal carers. Substitutionality appears to be the governing principle with formal and institutional services tending to step in only when the informal system breaks down. The achievement of greater complementarity between the formal and informal caring systems and the re-focusing of institutional services to provide support for the community care system as a whole are the suggested priorities.