As part of a grounded-theory study exploring the social processes of hospitalized older adults, family members were asked about their roles in relation to their hospitalized relative. Participants included five hospitalized older adults (aged ≥ 75 years), a family member, and a nurse for each older adult. Data saturation determined the number of participants. Data were analyzed using the constant comparative method to develop the substantive theory of managing personal integrity during hospitalization. Personal integrity is a concept encompassing the properties of health, dignity, and autonomy. Siblings, spouses, children, and grandchildren used a combination of supportive and directive behaviors to affect personal integrity and the hospitalization for their older relatives. In prior research, the entire family was viewed as the patient. This research is unique in that the family is viewed as a modifier of hospitalization affecting the older adult's hospital experience and not as the focus of care.