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Changes in Family Involvement Following a Relative's Move to a Long-Term Care Facility*

  • James W. Gladstone (a1), Sherry L. Dupuis (a2) and Evelyn Wexler (a3)


The purpose of this study was to examine changes in family involvement following a relative's move to a long-term care facility as well as factors associated with these changes. Qualitative data, using in-depth, active interviews were gathered from 35 family members at two points in time following a relative's move to a facility. Findings showed some changes in contact that were related to personal, social, institutional, and health conditions. Occasionally, new types of care were provided; more often care was rebalanced or expressed in alternative ways. The majority of participants did not view themselves as caregivers, a perception that remained stable over time. Consistent with continuity theory, families, in most cases, tended to seek ways to maintain consistency in their roles as family members and carers, particularly in the first year or so after placement. Nonetheless, facility staff should be aware of the factors that might influence changes over time in family caregiving roles and offer support to families dealing with these issues.

L'objectif de cette étude consistait à étudier les changements dans la participation de la famille après le déménagement d'un proche dans un établissement de soins de longue durée ainsi que les facteurs liés à ces changements. Des données quantitatives fondées sur des entrevues actives et approfondies ont été recueillies auprès de 35 membres des familles des patients à deux moments différents après le déménagement de leur proche dans un établissement. Les résultats révèlent certains changements, en matière de contacts, liés aux conditions personnelles, sociales, institutionnelles et médicales. Dans certains cas, de nouveaux types de soins ont été fournis ; dans la plupart des cas les soins ont été redéfinis ou fournis de manières différentes. La plupart des participants ne se voyaient pas comme des prestataires de soins, une perception qui est restée stable au cours du temps. Conformément à la théorie de la continuité, dans la plupart des cas, les familles cherchaient à trouver des manières d'adopter une approche constante en ce qui a trait à leurs rô les de proches et de soignants, surtout au cours de la première année qui a suivi le placement. Le personnel des établissements devrait néanmoins être conscient des facteurs qui peuvent causer des changements au cours du temps, du point de vue du rô le joué par la famille en matière de soins, et offrir du soutien aux familles qui doivent gérer ces questions.


Corresponding author

Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Professor James W. Gladstone, School of Social Work, KTH-319, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4M4. (


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The authors would like to thank the Alzheimer Society of Canada, Grant #00–05, for their generous support to conduct this research.



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Aneshensel, C.S., Pearlin, L.I., Mullan, J.T., Zarit, S.H., & Whitlatch, C.J. (1995). Profiles in caregiving: The unexpected career. San Diego, CA: Academic Press.
Atchley, R.C. (1989). A continuity theory of normal aging. The Gerontologist, 29, 183190.
Atchley, R.C. (1999a). Continuity and adaptation in aging: Creating positive experiences. Baltimore: John Hopkins University Press.
Atchley, R.C. (1999b). Continuity theory, self, and social structure. In Ryff, C.D. & Marshall, V.W. (Eds.), The self and society in aging processes (pp. 94121). New York: Springer.
Becker, G. (1993). Continuity after a stroke: Implications of life-course disruption in old age. The Gerontologist, 33, 148158.
Bitzan, J.E., & Kruzich, J.M. (1990). Interpersonal relationships of nursing home residents. The Gerontologist, 30, 385390.
Bowers, B.J. (1988). Family perceptions of care in a nursing home. The Gerontologist, 28, 361368.
Brody, E.M., Dempsey, N.P., & Pruchno, R.A. (1990). Mental health of sons and daughters of the institutionalized aged. The Gerontologist, 30, 212219.
Bury, M. (1995). Ageing, gender and sociological theory. In Arber, S. & Ginn, J. (Eds.), Connecting gender and ageing: A sociological approach (pp. 1530). Buckingham: Open University Press.
Chang, C.F., & White-Means, S.I. (1991). The men who care: An analysis of male primary caregivers who care for frail elderly at home. Journal of Applied Gerontology, 10, 343358.
Cohen, D. (2000). Caregivers for persons with Alzheimer's disease. Current Psychiatry Reports, 2, 3239.
Crispi, E., & Heitner, G. (2002). An activity-based intervention for caregivers and residents with dementia in nursing homes. Activities, Adaptation, and Aging, 26, 6172.
Dempsey, N.P., & Pruchno, R.A. (1993). The family's role in the nursing home: Predictors of technical and non-technical assistance. Journal of Gerontological Social Work, 21, 127145.
Duncan, M.T., & Morgan, D.L. (1994). Sharing the caring: Family caregivers' views of their relationships with nursing home staff. The Gerontologist, 34, 235244.
Dupuis, S.L. (2002). The roles of adult sons in institution-based elder care. Innovations: Enhancing Ability in Dementia Care, 1, 2.
Dupuis, S.L., & Norris, J.E. (1997). A multidimensional and contextual framework for understanding diverse family members' roles in long-term care facilities. Journal of Aging Studies, 11, 297325.
Dupuis, S.L., & Norris, J.E. (2001). The roles of adult daughters in long-term care facilities: Alternative role manifestations. Journal of Aging Studies, 15(1), 2754.
Dupuis, S.L., & Pedlar, A. (1995). Family leisure programs in institutional care settings: Buffering the stress of caregivers. Therapeutic Recreation Journal, 29, 184205.
Edelson, J.S., & Lyons, W.H. (1985). Institutional care of the mentally impaired elderly. New York, NY: Van Nostrand Reinhold.
Fry, P.S. (1992). Major social theories of aging and their implications for counseling concepts and practice: A critical review. The Counseling Psychologist, 20, 246329.
Gladstone, J.W. (1995). The marital perceptions of elderly persons living or having a spouse living in Canada. The Gerontologist, 35, 5260.
Gladstone, J.W., & Wexler, E. (2002). Exploring the relationships between families and staff caring for residents in long-term care facilities: Family members' perspectives. Canadian Journal on Aging, 21, 3946.
Glaser, B.G., & Strauss, A.L. (1967). The discovery of grounded theory. New York: Aldine.
Gottesman, L.E. (1974). Nursing home performance as related to resident traits, ownership, size and source of payment. American Journal of Public Health, 64, 269276.
Greene, V.L., & Monahan, D.J. (1982). The impact of visitation on patient well-being in nursing homes. The Gerontologist, 22, 418423.
Gubrium, J.F., & Holstein, J.A. (1997). The new language of qualitative method. New York: Oxford University Press.
Harel, Z. (1981). Quality of care, congruence, and well-being among institutionalized aged. The Gerontologist, 21, 523531.
Holstein, J.A., & Gubrium, J.F. (1995). The active interview. Thousand Oaks, CA: Sage.
Hook, W.F., Sobal, J., & Oak, J.C. (1982). Frequency of visitation in nursing homes: Patterns of contact across the boundaries of total institutions. The Gerontologist, 22, 424427.
Kayser-Jones, J. (2002). The experience of dying: An ethnographic nursing home study. The Gerontologist, 42, 1119.
Keating, N., Fast, J., Fredrick, M., Cranswick, K., & Perrier, C. (1999). Eldercare in Canada: Context, content and consequences. Ottawa: Statistics Canada.
Kellett, U.M. (1998). Meaning-making for family carers in nursing homes. International Journal of Nursing Practice, 4, 113119.
Kincheloe, J.L., & McLaren, P.L. (1994). Rethinking critical theory and qualitative research. In Denzin, N.K. & Lincoln, Y.S. (Eds.), Handbook of qualitative research (pp. 138157). Thousand Oaks, CA: Sage.
Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.
Linsk, N., Miller, B., Pflaum, R., & Vicik, A. (1988). Families, Alzheimer's disease, and nursing homes. The Journal of Applied Gerontology, 7, 331349.
Luborsky, M.R. (1994). The identification and analysis of themes and patterns. In Gubrium, J.F. & Sankar, A. (Eds.), Qualitative methods in aging research (pp. 189210). Thousand Oaks, CA: Sage.
Montgomery, R.J.V. (1983). Staff-family relations and institutional care policies. Journal of Gerontological Social Work, 6, 2537.
Nolan, M., & Grant, G. (1995). Developing a typology of family care: Implications for nurses and other service providers. Journal of Advanced Nursing, 21, 256265.
Patterson, J.M. (1988). Chronic illness in children and the impact on families. In Chilman, C.S., Nunnally, E.W., & Cox, F.M. (Eds.), Families in trouble series: Vol. 2, Chronic illness and disability (pp. 69107). Newbury Park, CA: Sage.
Patton, M.Q. (1990). Qualitative evaluation and research methods (2nd ed.). Newbury Park, CA: Sage.
Port, C.L., Gruber-Baldini, A.L., Burton, L., Baumgarten, M., Hebel, J.R., Zimmerman, S.I. et al. (2001). Resident contact with family and friends following nursing home admission. The Gerontologist, 41, 589596.
Pratt, C.C., Schmall, V.L., Wright, S., & Cleland, M. (1985). Burden and coping strategies of caregivers to Alzheimer's patients. Family Relations, 34, 2733.
Quayhagen, M.P., & Quayhagen, M. (1989). Differential effects of family-based strategies on Alzheimer's disease. The Gerontologist, 29, 150155
Reker, G.T. (1997). Personal meaning, optimism, and choice: Existential predictors of depression in community and institutional elderly. The Gerontologist, 37, 709716.
Riddick, C., Cohen-Mansfield, J., Fleshener, E., & Kraft, G. (1992). Caregiver adaptations to having a relative with dementia admitted to a nursing home. Journal of Gerontological Social Work, 19, 5175.
Rosenthal, C.J. (1985). Kinkeeping in the familial division of labor. Journal of Marriage and the Family, 47, 965974.
Ross, M.M., Rosenthal, C.J., & Dawson, P.G. (1997). Spousal caregiving in the institutional setting: Task performance. Canadian Journal on Aging, 16, 5169.
Schatzman, L., & Strauss, A.A. (1973). Field research: Strategies for a natural sociology. Englewood Cliffs, NJ: Prentice Hall.
Schwandt, T.A. (1994). Constructivist, interpretivist approaches to human inquiry. In Denzin, N.K. & Lincoln, Y.S. (Eds.), Handbook of qualitative research (pp. 118137). Thousand Oaks, CA: Sage.
Schwartz, A.N., & Vogel, M.E. (1990). Nursing home staff and residents' families role expectations. The Gerontologist, 30, 4953.
Shuttlesworth, G.E., Rubin, A., & Duffy, M. (1982). Families versus institutions: Incongruent role expectations in the nursing home. The Gerontologist, 22, 200208.
Smith, K.F., & Bengtson, V.L. (1979). Positive consequences of institutionalization: Solidarity between elderly parents and their middle-aged children. The Gerontologist, 19, 438447.
Stephens, M.A.P., Kinney, J.M., & Ogrocki, P.K. (1991). Stressors and well-being among caregivers to older adults with dementia: The in-home versus nursing home experience. The Gerontologist, 31, 217223.
Stoller, E. (1990). Males as helpers: The role of sons, relatives and friends. The Gerontologist, 30, 228235.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Newbury Park: Sage.
Tornatore, J.B., & Grant, L.A. (2002). Burden among family caregivers of persons with Alzheimer's disease in nursing homes. The Gerontologist, 42, 497506.
Whitlach, C.J., Schur, D., Noelker, L.S., Ejaz, F.K., & Looman, W.J. (2001). The stress process of family caregiving in institutional settings. The Gerontologist, 32, 665672.
Yamamoto-Mitani, N., Aneshensel, C.S., & Levy-Storms, L. (2002). Patterns of family visiting with institutionalized elders: The case of dementia. Journal of Gerontology: Social Sciences, 57B, S234S246.
Zarit, S.H., & Whitlatch, C.J. (1992). Institutional placement: Phases of the transition. The Gerontologist, 32, 665672.


Changes in Family Involvement Following a Relative's Move to a Long-Term Care Facility*

  • James W. Gladstone (a1), Sherry L. Dupuis (a2) and Evelyn Wexler (a3)


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