ALTHOUGH MANY CONTEMPORARY WRITERS CONSIDER LETTER-WRITING A LOST ART, some nursing scholars (Moules, zooz, 2.003) have written powerfully and passionately about the value of letters in clinical practice. Commendation letters, for example, are used in family health nursing to convey sincere praise to family members who have given exhaustively of their time and talents in the care of loved ones (Limacher & Wright, 2003, 2006). We have revivified the art of letter writing through student experiences, a component of our sophomore-level Foundations of Nursing course. Because our baccalaureate nursing program emphasizes interpersonal communication and the art of caring, students begin to formalize their understanding of human responses to health and illness through structured interaction with elders, residents at a regional nursing care and rehabilitation center. They then write letters as a therapeutic strategy for adult children whose family members are permanently institutionalized. The writing of the letters is a capstone experience usually reserved for the last day of postclinical conference. The focus is on special insights and learning they have gleaned through interacting with the elderly person over the course of five weeks. The Process Many of our students have considerable expertise with email and Instant Messaging, but few have actually taken the time to write a heartfelt letter. The idea of writing a thoughtful letter, filled with words carefully chosen and eternal, is daunting. As a result, we read an example (see Sidebar) that many use as a resource. We also provide university letterhead stationery, and require students to use black or blue ink. Family members who receive the letters are enlightened, since many are unaware of the extent and involvement of nursing students in the care of their loved ones. In addition, families are educated about the extent and involvement of their elderly relatives in the learning process for nursing students. The meaning of the elder in the life of a nursing student is profound. One resident's family member was so touched by the letter that she took time to respond, sharing considerable information about her mother as a much younger woman. She described how creative and civic minded she once was, and how the loss of her memory and other skills, through the process of disease and aging, had affected many people in the community, as well as her family. The student's letter served as a catalyst, helping to stimulate reminiscence and underscore the meaning of her mother's life. Responses to the letters have included verbal, written, and nonverbal expressions of thanks. To structure the process and provide respectful adherence to agency policies and protection of human subjects, faculty review all letters that students write, making editorial suggestions where needed. They also obtain consent from the nursing administration and social services and enlist the support of the agency social worker, who has agreed to distribute letters to family or guardians at the time of quarterly care conferences. In cases where family members are unable to attend care conferences, letters are mailed. Finally, all recipients of the letters receive a follow-up phone call from the agency social worker, who asks about how the letter was perceived. Benefits and Barriers The letters have therapeutic value for residents and families. Relationships with their loved ones take on new meaning when the family receives a letter from a student. Family members often include their loved ones in responding to student letters, taking care that thank you notes are hand signed or cosigned when possible. Residents say that they feel special to be the subject of letters from students. Some have asked to keep the letters in their rooms, and some carry the letters with them in purses or wallets - a reminder of precious time with nursing students. The letter writing works well as a teaching strategy, promoting relationships on several levels while meeting course objectives related to caring and communication in a meaningful way for everyone involved. …