Complementary Roles for Formal and Informal Support Groups: A Study of Nursing Homes and Mortality Rates

Abstract

Organizational theorists have argued that formal and informal support systems cannot exist in strong form in the same society. In this article, the author argues that such theories fail to consider the complementarity of these two systems and the necessity of both for the completion of most tasks. A study of tasks performed for nursing home residents found that the formal organization assumed those tasks that could be standardized and deemed legitimate for Medicaidfunding, while the others were either maintained by informal support groups or lost altogether. A study of the influence of informal support groups on mortality rates found that such groups played an important role in reducing death in older persons resulting from causes associated with nontechnical matters. In conclusion, the author finds that formal groups can best manage tasks that require technical knowledge or that can be reduced to simpler, routine components, whereas informal groups can better manage tasks requiring everyday knowledge and characterized by many contingencies or unpredictability. The author stresses that both formal and informal support must be provided when serviing older people.

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