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Working with elderly clients


This month here is an excerpt from an article I recently published in Therapy Today about my experience of working with elderly clients and how rewarding it is. Why do so few people consider working with the elderly? Why do so few elderly people consider counselling? For me it has profoundly affected me and helped me grow personally and professionally.

"Tom* was one of the first clients I worked with during my training – a 95-year-old man who was referred to me by a nurse in his residential care home because he was struggling to adjust to life alone after the death of his wife. I was terrified. What could I possibly do to alleviate the distress of a man at the very end of his life? As I went to the care home for our first session, I felt inescapably young and impotent before the tidal wave of grief, ill health, powerlessness and distress that I imagined I would meet.

Tom died, suddenly, after we’d had just six sessions together. But, in those six weeks, he turned each of my presuppositions on their head. I learned a lot about myself, what I wanted to do in my counselling career, and what it means to experience love and loss in the therapeutic encounter. Above all, he changed the way I view life, ageing and death, and, crucially, how to work therapeutically with people who are approaching the end of their lives.

I believe that counselling is an emancipatory and political act: by engaging in it, we can liberate ourselves to be all that we can be. I often feel, in my role as a counsellor, that I am mounting a tiny insurgence against a world that celebrates certainty and puts people in social and cultural boxes. Society tends to objectify and isolate the elderly; to regard everyone over a certain age as an amorphous mass, rather than a collection of unique individuals with rich, unique stories. Often, older people find themselves excluded from psychotherapy services, unable to access them due to poverty or physical disability, and seek support instead from non-profit organisations. Depression affects around 22% of men and 28% of women aged 65 years and over, yet it is estimated that 85% of older people with depression receive no help at all from the NHS. Society seems to expect a certain amount of depression in people over 65; it goes with the territory, as it were. Is this OK?

As counsellors, our role is to recognise, encourage and celebrate the unique individuality of our clients and to explore their reality. When I first came to this work with older people, in the conceit of youth, I believed that self-actualisation was not feasible in the last stage of life and the best I might hope to offer my clients was the alleviation of their distress. The work has profoundly challenged my preconceptions."

If you'd like to read more about this you can download the article here

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