Therapy for older adults
Later life brings real losses and real medical demands, and that is not a reason to expect less from therapy. It is the same work, adapted to the body and the circumstances you have now.
A free 15-minute call first. I usually reply within 2 working days.
You might recognise
- I have a doctor for every part of me and nobody who sees the whole.
- I do not want to be a burden, so I have stopped saying when something is wrong.
- My husband is the patient. Nobody has asked how I am in two years.
- I sleep badly and I have no appetite, and I am told this is natural at my age.
- Everyone assumes I am fine because I manage on my own.
- I have started avoiding things I always did, and each time it is harder to go back.
Why it happens
Later life concentrates several demands at once. Medical appointments multiply, the medication list grows, and a great deal of energy goes into arrangements that used to be automatic. Fatigue, pain and poor sleep affect mood directly, and that effect is usually attributed to age rather than to whatever caused it. Losses accumulate. A husband or a wife, siblings, friends, a profession, a driving licence, a familiar body. Each is a genuine bereavement, and there is rarely a long enough gap between them to grieve properly. The social world contracts at precisely the point where it is most needed. Independence runs through most of it. Accepting help can feel like conceding something permanent, so people manage alone well past the point of comfort, and say less to their children in order not to worry them. That protective silence is usually well intended and it is expensive. There is also a widespread assumption, including among some clinicians, that depression and anxiety in later life are understandable and therefore not treatable. That is not what the evidence shows. Psychological treatment works in older adults, and long-standing patterns can still change. Being eighty does not turn a difficulty into a fixed feature.
How therapy helps here
- Integrative individual therapy at an unhurried pace
- Sessions combine looking back over a long life with practical work on the present. The pace, the length of the session and how much we cover in an hour are adapted to your energy and concentration rather than to a protocol.
- CBT adapted for illness, pain and sleep
- Structured work on activity that has shrunk, on sleep that has drifted, and on thoughts such as there is no point starting anything now. The steps are small, concrete and agreed, and they start from the medical reality rather than ignoring it.
- Grief work for accumulated losses
- Bereavements that arrived one after another, and losses that are not deaths - a home, a role, a capacity - are each given separate attention instead of being piled into one undifferentiated sadness.
- EMDR for a memory that will not settle
- An old event, a wartime memory, or a frightening recent admission can be worked on directly. Age is not a contraindication, and we adapt the method to what your body and attention allow.
- Support for the partner who is doing the caring
- Caring for a spouse with dementia or a chronic illness carries its own load, including guilt, anger and anticipatory grief. That is a legitimate reason to come, in your own right and not only as an extension of their care.
What the first sessions look like
- The first session includes some practical setting up: sound, screen size, headphones, and who else is in the house.
- We go through the medical picture and the medication list, because both affect mood, sleep and concentration.
- You tell me what you would like to be different. If that is hard to answer, we start from an ordinary week and work back to it.
- We check together whether the online format suits you, and we agree what happens when a session is missed.
Wanting something for yourself at this stage is not self-indulgence. You are not too old for this, and you are not taking a place from someone who needs it more.
What this does not replace
Therapy does not replace medical care, psychiatric assessment, a medication review or the investigation of memory difficulties, and it does not diagnose dementia. Where there is cognitive change, significant depression, or a risk to your safety, an in-person and multidisciplinary assessment is more appropriate and I will help you reach it. Online work does not suit everyone - significant hearing or vision loss, unfamiliarity with the technology, a home without a private room, or difficulty holding attention on a screen can all make it the wrong format; we look at this together in the first sessions, and I will say plainly if I think in-person therapy would serve you better.
Common questions
How long is a session and what does it cost?
An individual session is 45-50 minutes and costs €130. A group session is 90 minutes and costs €70-100. All sessions are online, in Hebrew or English.
I am not comfortable with computers. Will this work?
Usually yes, with a little setting up in advance. We do a short technical run-through before the first session, someone in the family can connect you once and then leave the room, and if after a few sessions the format is getting in the way, I will say so and suggest in-person alternatives.
Is it not too late to start therapy at my age?
No. The response to psychological treatment in later life is comparable to that in earlier adulthood, and the goals are usually concrete: sleeping, going out again, grieving properly, deciding something. Long-standing patterns can also still move.
Can a family member be present?
A relative can help with the technology and can join the beginning of a session if you want, and then the session is yours alone. What is said in it is confidential, and I do not report back to your children.
What happens if I get tired, or a health problem interrupts the treatment?
We can shorten a session, take a break, or pause the work for a period of admission or recovery. Interruptions are expected here, and they do not mean starting again from the beginning.
Related areas
Chronic illness and diabetes
For living alongside a long-term diagnosis: the appointments, the numbers, and the self-management that never quite finishes.
Read moreAnxiety and health anxiety
For health anxiety and worry that follows the body: checking, searching, and reassurance that never lasts.
Read morePTSD and medical trauma
Intrusive memories, avoidance and heightened alertness after a frightening medical event or another trauma. EMDR and related evidence-based work.
Read more
Unsure whether to write?
Write one sentence about what is going on. I will say if I work with that, and if not, where else to look.
A free 15-minute call first. I usually reply within 2 working days.