Whereas Europe and America formerly had policies to encourage the elderly to enter nursing homes, the proportion who actually entered homes has never in fact been very high. With costs rising out of control, from the 1980s these nations began to shift their policies to favor the establishment of community based care networks.
林萬億指出，早期歐美各國的老人政策多以興建老人安養機構為主，然由於機構照顧的成本過高，再加上老人進住機構的比例確實偏低，八○年代開始，各國老人照顧方式，逐漸由機構轉移到社區，以社區為範圍，建立照顧網絡。