As technologic interventions such as long-term gastrostomy in children with severe disability become commonplace, and increasing numbers of medically complex children are cared for in the home, nurses will require specialized knowledge to support families. In this article, the authors document findings from a longitudinal study of families caring for a child with a gastrostomy, specifically addressing the caregiver perspective on how families cope with this challenge. The findings reveal a complex set of effective coping strategies as articulated by family caregivers experienced in the management of long-term gastrostomy. Further, these caregivers reveal insights about gastrostomy's technical, social, and psychologic implications for both themselves and their children. In documenting an insider perspective on this phenomenon, this study provides nurses with a comprehensive orientation to the ways in which healthcare professionals can better support family caregiver coping.