Dreams of Hot Toast and Smiling Nurses: Toward a Model of Patient-Responsive Care in Nursing Homes

The problems of providing high-quality care in nursing homes have been extensively documented. Accounts of residents, close family members, and qualitative researchers have described feelings of desperation, anomie, and hopelessness, which accompany the last years, months and days of those reluctantly finding themselves in institutional facilities at the end of their days. However sociologists have, thus far, paid little attention to the actual and potential impact of families in breaking through the barriers set up by institutional life and in enhancing the responsiveness of care in nursing homes. This chapter aims to fill this gap.