Institutional logic and everyday practice of the long-term care system

About the author:

Vladimir R. Misikhin, Cand. Sci. (Soc.), Senior Researcher, Russian Presidential Academy of National Economy and Public Administration (RANEPA), Moscow, Russia.

misikhin@mail.ru, https://orcid.org/0009-0000-3653-2349

Abstract:

This article examines the interaction between the institutional logic of the long-term care system (LTCS) and the everyday practices of caregivers. Drawing on data from a qualitative sociological study (2025, Republic of Khakassia and Yaroslavl Oblast, n = 68), the author reconstructs how managerial requirements, professional decisions, and subjective experiences intersect. The managerial logic is oriented toward standardization and formal indicators, whereas in actual caregiving practice, the key roles are played by the discretion of care workers, their emotional labor, and their ability to adapt to specific life situations. The scientific novelty lies in considering the LTCS as a process in which institutional demands confront and align with moral-relational practices. The main conclusion is that the sustainability of the LTCS rests not only on formal regulations but also on the daily work of adapting standards; therefore, managerial decisions must take into account the relational nature of care.

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