INTRODUCTION:
The increase in longevity in Brazil and worldwide has brought several challenges to be faced by society and policymakers, among which is the increased demand for Long-Term Care Facilities for the Elderly (LTCFs). Historical and cultural transformations have been modifying the relationship of home care, predominantly carried out by women. However, access to LTCFs by the Brazilian population is still limited, especially in contexts of greater social inequality. This study aims to discuss home care for dependent elderly people from the perspective of family caregivers and the limitations of public policies aimed at long-term care.

METHODS:
This qualitative, cross-sectional study was conducted in the state of Espírito Santo, Brazil. Fifteen family members who actively cared for elderly individuals at home participated in the research. The study adhered to the ethical guidelines of Resolution No. 466/2012.

RESULTS:
Home care for elderly people in Brazil is a social imposition, as elderly women assume this role without technical training and under intense physical, emotional, and economic strain. The absence of state support means that care is provided without a support network, potentially increasing the health of the caregiver and compromising the care of the elderly person. Long-Term Care Facilities for the Elderly (LTCFs) were recognized as a care alternative. However, they proved inaccessible to some participants, as the elderly person's retirement income was insufficient to cover expenses, making it impossible to contract the service.

CONCLUSIONS:
The institutionalization of elderly people tends to increase with population aging. Although LTCFs present themselves as a care alternative, access is restricted and unequal, highlighting difficulties for the State in guaranteeing equity in access and ensuring quality standards in care. The findings reveal weaknesses in public policies and reinforce collective care as a necessary agenda in the face of accelerated population aging.