While many families and relatives are very supportive and grateful for the care their loved one receives in the nursing facility, some families present challenges. The social worker in the nursing home encounters not merely the issues of resident illness within the context of an institutional setting, but the broader issues and concerns of the family members as well. Families can arrive with a multitude of feelings, from confusion to anger, hostility, and even explosive sentiments. In some cases, experiences in the hospital setting may trigger ire that is then directed at the long-term healthcare system. Sometimes, it is merely the frustration that their loved one has not recovered sufficiently to return to their former level of functioning. In other circumstances, the family dysfunction has existed for many years, complicating communication and exacerbating the challenges of illness and recovery. Social workers in nursing homes can be in very influential, important positions to aid and support residents and families through placement, discharge, or long-term stay. Social workers are also able to assist with appropriate limit setting for families. Acknowledging the struggles of a new admission or demands of a specific family/representative is an important step in communication and trust building. At the same time, it is important to help families understand the constraints of staff and how to manage communications as well as having consideration for all the facility’s residents. It is through professional social work training and education that social workers can help negotiate and advocate for those in need.