Medical and Familial Claims to Long-Term Care: Institutional Gaps and Shifting Jurisdictions

In light of the contemporary long-term care crisis, Sandra Levitsky's book Caring for Our Own examines why there has been no movement to secure state support for caregivers. Speaking to sociolegal and social movement audiences, Levitsky reveals how lack of collective identity, the power of family-based ideologies, and the separation of support organizations from political ones help to repress mobilization. In this essay I refract Levitsky's findings through the lens of organizational theory and medical sociology. I argue that the social problem of long-term care is caught in an institutional gap since it does not readily fall under the purview of either medicine or family. I also discuss the implications of lay caregivers' provision of sophisticated medical care for theories of professional jurisdictions and gatekeeping.