Better late than never: of reminiscence and resolution

My purpose in writing this article was to offer observations and helping strategies to nurse-colleagues who deal with depressed elderly. The process begins (as always) with careful assessment and a willingness to adapt strategies to changing needs. Change is expected--both in assessment data and in clients' behavior. This model is client-driven. The client defines her needs, her goals, her feelings, and her solutions. When the nurse offers suggestions, it is only to "prime the pump." The nurse must have no vested interest in the ultimate use of those suggestions. In fact, there is cause to rejoice when a client discards them in favor of her own. The nurse must avoid being cast in the role of referee or judge in working with Angry Depressed clients. Who is "to blame" in clients' ruptures with the family and/or friends is outside the nurse's area of concern. The focus is on healing those ruptures if the client wishes to do so and for the client's sake. Within the framework of Erikson's eighth stage, the client's task has been to resolve the tension between the polar extremes of integrity and despair. The tools at hand for accomplishing this task have been the client's intrinsic strengths and the nurse's professional skills. "Dorothy" and "Julia" have had some degree of success in this endeavor, placing them at positions closer to integrity on an integrity-despair continuum. Others have had less positive resolutions. Still others are "in process." One woman in her 80s has resumed telephone contact with her daughter after a long hiatus, but is still estranged from her son.(ABSTRACT TRUNCATED AT 250 WORDS)