Family caregivers are of great importance in nursing homes, especially for people with dementia. Nowadays, person-centered models of care are prominent in dementia care and emphasize strengthening residents’ autonomy and overall well-being (Verbeek et al. 2009). Older people should be enabled to continue their lifestyle as before admission to a nursing home. Program design should ensure that residents are known as people. Family caregivers play an important role to establish this, for example, by providing the historical background for residents, make care decisions, provide personal and social care, and are advocates for people with dementia (Port et al. 2005). Family members aim to maintain a sense of personhood for people with dementia residing in nursing homes, as it is important for family that their loved one is treated as an individual (Sandberg et al. 2001; Bramble et al. 2009). Literature shows that family caregivers remain involved in the lives of their loved ones following admission into nursing homes (Gaugler 2005). This evidence is important to battle against the myth that families abandon their relatives in nursing homes (Rowles et al. 1996). The decision to admit people with dementia into a nursing home is very emotional for family caregivers and triggers feelings of guilt and loss and most relatives want to stay actively involved in the care process (Tornatore and Grant 2004). Family caregivers feel continuing the responsibility for care often after admission, although they are relieved from their round-the-clock care at home (Ross et al. 2001).

Family involvement in long-term care is a multidimensional construct and consists of aspects such as visiting, advocacy, monitoring, and providing socio-emotional, instrumental, and personal care (Gaugler 2005). Looking at more quantitative aspects of family involvement, previous studies have investigated the visiting frequency, duration, and type of care tasks family members conduct. A European study showed that family caregivers visited overall approximately 3–4 times a week, with an average duration of over 100 min (Bleijlevens et al. 2015). There were, however, large differences between countries. In northern countries such as Estonia, Finland, and Sweden, visits were less frequent (around 2 times a week), while in other countries such as Spain, visits were more frequent, up to 5 or 6 days a week (Bleijlevens et al. 2015). Other studies suggest that on average, family caregivers visit and/or provide care between 4 and 9 h per week (Gaugler et al. 2004; Port et al. 2005). Tasks that family caregivers conduct include a wide range of personal, instrumental, and socio-emotional tasks, such as grooming, clipping fingernails, doing laundry, shop for the resident, writing letters, maintaining the apartment, and dealing with family guilt feelings (Gaugler 2005). Furthermore, family members felt responsible for new dimensions of assistance not originally engaged in the community, such as promoting family understanding of nursing home policies, initiating actions to ensure good staff/family relations (Gaugler 2005) as well as supervision and monitoring of quality of care (Moss et al. 1993; Max et al. 1995), representing and maintaining residents’ continuity and connectivity with other family members and friends (Bern-Klug and Thompson 2008). However, a considerable amount of role ambiguity can be apparent, as staff felt that a particular task was the responsibility of the nursing home, whereas families felt that certain care tasks remained their responsibility (Gaugler 2005). Family members themselves stress the importance that preserving the identity of their relative could only be accomplished through collaborative efforts with staff (Gaugler 2005). They often perceive effective involvement as being a teaching resource to nursing staff, so that staff members would deliver sensitive, person-centered individualized care to the person with dementia living in the nursing home.

The building of a partnership between families and staff is increasingly advocated as a means to ensure high-quality care in nursing homes (Penning and Keating 2000). To enhance the feeling of belonging and dignity for people with dementia, a collaboration between family and nursing home staff should be established. For realizing person-centered care and continuation of own lifestyle for people with dementia living in a nursing home, family should be seen as partners in the care for residents instead of visitors (Holmgren et al. 2013). Goals should include family members of people with dementia in nursing homes as this is important to support residents and also to support family members. Previous research indicates that when nursing staff members become more involved with family caregivers and keep open lines of communication, family caregivers’ satisfaction increases, which improves their feeling of confidence that their loved one is well being cared for (Volicer et al. 2008; Piechniczek-Buczek et al. 2007). Family-perceived involvement was significantly and positively correlated with satisfaction and impressions of the facility (Irving 2015). Elements considered as most important by family members were the feeling that residents were well cared for, having trust in the staff of the nursing home and being informed about changes in the residents’ care plan.

Realizing a partnership in every day care practice can be challenging, as both family caregivers and staff experience barriers. When people with dementia move into a nursing home, they and their family have to adjust and follow nursing home rules and routines (Bauer and Nay 2003). Family members often feel guilty over the decision to place their loved one into a nursing home. During the transition, they express a high need for information about the transition and would like to be recognized as an expert in knowing the loved one (Afram et al. 2015; Abrahamson et al. 2009; Chen et al. 2007; Givens et al. 2012). Staff members discover that the new resident brings family members who both expect continued involvement in care and need information and attention (Hertzberg et al. 2001). Staff-family relationships evolve in a social and physical environment that is familiar to staff, but is foreign to family members, who find themselves in a strange place with new roles to play and complex rules to interpret (Utley-Smith et al. 2009). Establishing and maintaining an effective staff-family relationship can be challenging for both parties. Four main barriers can be identified that hinder collaboration between staff and family: attitude and role conflict, communication, knowledge, and organization.