The applicant's long-term objectives are to develop a grounded theory of caregiving, The development of such a grounded theory can be pursued through a variety of research endeavors focusing on different types and combinations of caregivers, different populations of caregiving recipients, different micro (immediate environment) contexts of caregiving or different macro (socio economic systems) contexts of caregiving. The current study incorporates two caregiver types (nurses and nurseaides in long term care of the elderly) and two micro contexts, (nursing homes and home care). The two contexts have been explored previously by the applicant through the perspective of family caregivers. This study will add depth and complexity to the theory being developed by looking at different types of caregivers in the same two contexts. Specific aims for this study are: 1) to gain an understanding of how nurses and nurse-aides caring for the elderly in the home and the nursing home conceptualize and provide direct care and the relationship between conceptualization and practice, 2) to gain an understanding of how nurses in these two settings provide indirect care to the elderly through supervision of nurse-aides, and 3) to incorporate these findings into the caregiving theory developed by the applicant's previous studies of family caregiving in the same two settings. As with the previous studies, the grounded theory method will be used. Data will be collected by a combination of participant observation and indepth follow-up interviews with nurses and nurse-aides. Data analysis will be conducted concurrently with data collection by the principal investigator, a research assistant, and an analysis team. The findings will provide insights into how collaboration among nurses, nurse-aides, and family members can be enhanced to increase the quality of caregiver interactions and, consequently the quality of care to frail older adults.