A multidimensional and contextual framework for understanding diverse family members' roles in long-term care facilities

Very few studies have explicitly examined the roles of family members in institutionalized settings and how these roles are developed. The most widely used theoretical framework employed in the studies that do exist is Litwak's structural-functionalist framework—the theory of shared functions and balanced coordination. Although Litwak's theory emphasizes the importance of both formal organizations (e.g., long-term care facilities) and primary groups (e.g., family) to optimal care, the framework provides a limited understanding of the roles of family members in long-term care facilities. The first section of this article describes Litwak's framework and then outlines the limitations of this task-assignment approach. By adopting a symbolic interactionist approach and integrating concepts from an ecological perspective and Hughes' concept of career, an alternative, more dynamic, contextual framework for understanding the roles of family members in long-term care settings is presented.