This study was performed in six Long-Term Care Institutions for the Elderly (LTCIEs) that helped low-income senior citizens in three regions of the country. Its aim is to examine how LTCIEs' internal organizational system maintained structural coupling with surrounding systems. The data were collected through interviews and observation. The analysis was based on concepts of Luhmann's Social Systems Theory. As a result, the rules of belonging did not encourage aid proposals that stimulated independent life and the individuality of residents. The structural couplings with the external environment generated negative resonance within LTCIEs, such as the lack of links to programmatic actions of public primary health care, inability to maintain a multiprofessional staff, inability to fully adapt the infrastructure, and inability to bring reçatives closer to the institution's daily routine. As a positive aspect, the staff was empowered by the presence of students and their professors.
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