Little research has focussed on the perspectives of families caring for someone with severe or profound intellectual disabilities and challenging behaviour. The main aim of this research was to gain understanding of the experiences and perspectives of families, especially mothers, of young people with these complex needs, including attitudes to long-term residential care. Ethnographic methods were used, consisting of intensive interviews over 2 years, mainly with mothers, and participant observation. The analysis used grounded theory. The mothers' main focus was on their son or daughter with intellectual disabilities. Most were socially isolated, even from close kin. Their negative attitudes to institutions and fears for the safety and well-being of their sons and daughters led to determination not to put them into long-term care. Mothers struggled to care for the young people at home, in spite of difficulties, family tensions and social isolation. Lack of effective services, especially around transition to adulthood, increased parents' protectiveness.