The social-ecological approach are cross-level influences shown by arrows that cut across levels indicated in the figure. Thus, family consensus, a supportive division of labor, and appropriate information gathering at the level of social relations may support individual cultural expectations about home care. Likewise, a consistent relationship with service providers at the level of the neighborhood may reinforce proadaptation resources at the level of the family, such as willingness to include home health care staff as “family,” and a reasonable division of labor with home care providers.