A fire on a geriatric ward of a state hospital led to the moving of all the patients, changes in personnel, and a different routine. A marked increase in the death rate followed these changes, attributed to 'disruption of the everyday structure of life, drastic change of physical environment, discouragement of personnel, and, for some patients, actual separation from the group'. The author compares these reactions to the anaclitic depressions described by Spitz, and describes the similar sequence of reactions: physical deterioration, susceptibility to disease, and finally death. Like infants, in order to remain alive the most regressed of these senile patients require nursing care which is more than something technically efficient and impersonal.