A new environment is particularly stressful for the elderly, and it often aggravates existing health and emotional problems. The elder, surrounded by unfamiliar faces, feels a sense of isolation. Four phases of adaptation to life in a long-term care facility have been identified: disorganization, reorganization, relationship building, and stabilization. A central factor in the psychological response of elders to entering a nursing home is their perception of how much control over their life will be lost. Nurses must advocate for as much resident control as is realistic; they must mediate between resident and environment, and sometimes between resident and family.