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As part of a comparative study of the institutionalized elderly in London and New York, random samples of nurses' aides, nursing assistants and care assistants were interviewed. It is shown that the two long-term care `systems' employ very similar people to provide basic care services, but far more in-service training is provided for New York staff. A detailed analysis of tasks performed suggests that New York staff may be more likely than their London counterparts to carry out technical `nursing' procedures and to be actively involved in physical rehabilitation. The preferences of staff in caring for more or less dependent people showed considerable cross-national agreement, almost half of the total respondents reporting that they preferred immobile patients. Some of the reasons they gave are presented and the implications of this finding discussed.