question: Mr. Black age 89 has multi-infarct dementia with severe memory loss ,impaired judgement and mood swings. He is also profoundly deaf and has some visual problems. He is increasingly weak and unsteady on his feet and needs to be supervise and assisted living centre in a long term care facility. He won t join any activities and often refuses to go to the dinning room for his meals.sometimes he expresses angry outbursts and is often found crying in his room. He says that he should be able to go out and have a job again.he feels that everything has been taken away from him and often expresses that his life is worthless and he wishes he die. Mrs. Black visits her husband everyday and attempts to rationalize with him and talk him out of his bad moods she appears to care for him very much and often tidies his room and changes his clothes. He usually unloads all of his feelings on her and she goes away feeling frustrated and guilty..how failing physical health brain damage ,institutionalizations and loss have affected mr black mental health and promoted a cycle of deterioration.