What Practitioners Should Know About Working With Older Adults

Executive Summary

This publication is designed to give psychologists and other health care providers important information to help guide their work with older adults.

Clinicians need to know more about this age group because the number and proportion of older adults in the population are increasing, and more psychologists will be called upon to deliver psychological services to them.

Older adults are defined as persons 65 years of age and older. The population of older Americans is itself getting older. The "oldest old" group, those 85 years and older, is increasing faster than any other age group. Unfortunately, there are numerous negative stereotypes about older people. The reality is that most older people live independently and maintain close relationships with family and friends. Personality remains relatively stable throughout the lifespan, and community dwelling older adults have lower rates of diagnosable depression than younger adults.

However, older adults do experience age-related changes--both physical and cognitive. Common age-related physical changes include hearing impairment, weakening vision, and the increasing probability of multiple chronic conditions such as arthritis, hypertension, heart disease, diabetes, and osteoporosis. While there is some degree of cognitive impairment, cognitive changes in older adults are highly variable from one person to another, but can include decline in information processing speed and memory problems. These changes do not typically interfere with daily living. Because a large number of older adults take several medications, drug interactions and drug side effects are more common than in younger age groups.

In assessing an older adult, the practitioner may have to modify the testing environment to assure optimal performance. Any assessment of an older adult should include the client's current mental status, cognitive ability, social supports available to the client, the client's medical status, and, if cognitive impairment is suspected, interviews with family members and close friends.

Research indicates that psychological interventions that historically have proven effective with younger and middle-aged adults are also effective for older adults. Specifically, cognitive-behavioral, brief psychodynamic, and Klerman and Weissman's interpersonal psychotherapy have been shown to be effective in the treatment of one or more late-life mental disorders.