The homebound comprise a specific group of people whose mental handicaps, chronic illness or frailty confine them to their homes. It is difficult to define exactly when a person is homebound, but such a person has been described as being unable to leave the house or garden without some mechanical assistance such as a stretcher or a wheelchair. In fact, with the exception of mental illness, especially dementia, the frail older adults living outside nursing homes may not be very different from those in nursing homes.