Although survival of older burn victims has improved significantly in recent years, controversy remains over the care that should be given to this group and the functional recovery of survivors. To assess the impact of burn injury on lifestyle in the elderly, we conducted a mail-in survey among surviving patients ages 45 years or older who were treated in our burn center from 1978 to the middle of 1987. The survey asked questions about living arrangements, personal care, family relations, social life, work status, and outlook on the future. Of 168 surveys mailed, 109 were completed and returned (64.9%). Responders consisted of 82 men and 27 women with a mean age of 57.8 years (range, 45 to 92 years). Ninety-seven percent of patients were able to return home after discharge, but 27% of the oldest patients (ages greater than 75 years) required permanent placement in extended care facilities. With increased age there was an increased tendency toward dependence and the need for assistance in daily living; half of the oldest patients required assistance in daily living. Even so, most of the patients in this survey remained independent and maintained a positive outlook on the future. These results appear to justify a policy of aggressive treatment for elderly burn victims.