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Published Online:https://doi.org/10.1176/ps.35.10.1029

Many older, severely dependent patients in large psychiatric hospitals, who are often inadequately treated with traditional psychiatric approaches, have no realistic chance of improving or of returning to the community. At Marlboro (N.J.) Psychiatric Hospital, two programs—a senior citizens center and a transitional house-were founded in 1979 and 1981, respectively, to maximize productive life roles for clients. After discussing the goals, admission criteria, and activities of each program, the authors present a profile of a patient who had shown little progress during 15 years of hospitalization but whose participation in the programs facilitated her return to the community.

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