Goffman revisited: Relatives vs. administrators in nursing homes

This case study applies Goffman's total institutions paradigm to a skilled nursing facility and shows that his characterization of relatives as collusive agents in a betrayal funnel is more accurate in the prepatient phase than after admission. When they encounter administrative resistance to their suggestions, some relatives become militant reformers. This paper describes ten gatekeeping tactics employed by administrators to neutralize such relatives, and four gatestorming tactics utilized by relatives to affect change. The author concludes that while Goffman's work is still relevant, his tendency to stereotype total institutions is misleading and his manner of reporting field work obscures the true role of the participant-observer.