Dear Director D.E. Smith, RN,*

Thank you for your call yesterday regarding my mother's welfare. I have been reflecting since our conversation on your and care staff's concerns for her. As you related, they have observed that she is especially mournful in the late afternoon. Oftentimes, she asks the staff for the whereabouts of her husband, my father. According to the care staff, she cannot accept that he died many years ago. When told that the Care Center is now her home and they will always take good care of her, she becomes argumentative. In fact, some staff think that she is sundowning and thus confused. I have recorded my thoughts about what might be the source of her dismay in this letter so that you can share it with the certified nursing assistants directly. I regret that I live so far away but will be there soon for a long visit.

The following is what I think could be the source of her dismay, which always surfaces in the late afternoon and early evening. My mother and father were very close. One of the most enjoyable times for them was when he came home from work in the late afternoon and they shared dinner and conversation. They were together for 65 years and both worked in the community and also on church projects together. His presence will always be with her. However, what unsettles her is that she is not in her own home but in a foreign place among strangers who come and go all day, every day. Many do not know her nor does she recognize them. She does not accept the Care Center as her home. She insists that she is only staying there while she recovers from a hip fracture. In her 95th year, and now forgetful, she cannot soothe herself and calm her fears as she once did as a younger person of strong character and will.

In her loneliness, she looks for the most important person in her life for comfort and cannot find him, only many strangers in a strange environment. Of course, inwardly, she somehow does know that he died several years ago. It's as though, at present, she is in a spiritual and physical exile. It would, I believe, help her greatly if she were held and consoled with these words: "your husband was a very fine man[horizontal ellipsis]a good man[horizontal ellipsis]with a grand sense of humor[horizontal ellipsis]he will always be with you." These are soothing words based on a reality that she knows and needs to hear. Most likely, these words would have to be repeated each late afternoon. Otherwise, she is left alone among strangers, forlorn, bewildered, and frightened.

I hope my thoughts will be helpful to the care staff. I welcome their responses.

Once again, I greatly appreciate your staff's concerns for my mother's welfare.

Sincerely,

A. J. White*

*Generic names and place. [Context Link]