ABSTRACT
Mrs. Smith, an 85-year-old resident of a nursing home, was transferred to the hospital for treatment of pneumonia. Although she has responded well to antibiotic therapy, her overall condition and prognosis remain grim. For the past 3 years her mental state has been steadily deteriorating due to a series of strokes which have finally rendered her severely demented. She is now nonambulatory, incapable of sitting up in bed, and uncommunicative most of the time. When she does talk, her speech is completely incoherent and repetitive. Mrs. Smith shows no signs of recognizing or remembering her family and primary caregivers. The nurses in charge of her care assert that she appears to experience pleasure only when her hair is combed or her back rubbed.
