The serious and life threatening nature of acute/critical illness in frail elders often necessitates use of advanced technology for diagnosis and treatment. Physical and/or chemical restraints are frequently used to prevent self-removal of technologic devices, termed "treatment interference." Existing research suggests that agitation, anxiety, confusion, and discomfort may be factors contributing to treatment interference; however, a complete description or explanation of treatment interference in hospitalized elders is lacking. A gap exists in knowledge about the ways nurses respond to treatment interference in hospitalized elders. Alternatives to restraint use for the prevention of treatment interference in technologically complex environments has been unexplored. The purpose of the proposed study is to examine the circumstances whereby elderly patients remove or attempt to remove technologic devices and nurses' responses to this common, but perplexing, clinical problem. Specifically, this study aims to produce a grounded theory that: 1) describes the process of "treatment interference" in critically ill elders, 2) contributes to an understanding of the meaning of self-removal of technologic devices, and 3) provides a framework for the identification of the most effective, humanistic, and acceptable nursing responses to treatment interference.