Gail--Thinking about this post... I think most families are compelled to place their loved ones in care facilities because the basic care (toileting, eating, dressing, washing, lifting) become too much for them. These families aren't necessarily exhausted by simply spending time with their loved ones--in some cases this time becomes more enjoyable once the other obligations are met by the facility--but the entire "package" is no longer doable for the average spouse, daughter, son, etc. How to acknowledge that caring is a joint effort? From all accounts, residents whose families are involved also get better care from the staff. And I think there's more to this than meets the eye--I don't think it's simply a matter of the staff members feeling like they're more accountable because the family members are around to watch them. I think--at least from my experience--that they come to know the resident more intimately by knowing the family and, by the same token, if family members take a few minutes to get to know them then some kind of relationship is formed. In a longterm situation, at least, it's important for the family to carve a place for themselves--aside from the "we're paying you to do the work" relationship.