Many people incorrectly assume that, along with skilled care, nursing homes are an effective substitute for the warmth and intimacy of the family. Few are prepared for the shock of institutional placement. Most families are ill-informed about the vital role they can play in the care of their frail elder. Katherine Karr's personal and poignant account of the care provided to her grandmother during a difficult institutional experience encourages family members to take greater responsibility for ministering to their loved ones within the nursing home setting.Karr's clear, concise, step-by-step instructions address the physical, mental, emotional, and spiritual components of caregiving. Advocacy and medical self-care are central themes. Her practical and comprehensive guidelines will help families effectively supplement care, thereby becoming integral to the caregiving process. Challenging the traditional positions that have encouraged patient/family passivity and compliance, she returns the focal point of attention to the unique role that family plays in enriching the lives of nursing home residents. Promises to Keep provides a manual for training family members, nursing home volunteers, community agencies, and support/advocacy groups.