Many of us project an image onto the elderly that’s not universally true. The image says that older people can’t or won’t change their behaviors, even if those behaviors are no longer functional. Resistant to change and embedded in the past is how we think of many older clients. With a sigh we might halfheartedly suggest slight changes in behavior, but when that fails, we give up and attribute the failure to the person being “set in their ways”.
Our approach to therapy with seniors may be partially at fault. Many seniors do not want to go back to their distant past and work their way forward. They have no desire to bring out past traumas and investigate how those events have produced who they are in the present. No matter how excellent those approaches are for those of middle to earlier years, they have a tendency to turn off seniors. “A lot of that I don’t remember,” is a phrase therapist hear from older patients. Perhaps we think that is evasive. It is not, it most cases. We forget, and if the age difference between us and our client is vast, with the client holding the greater age, we have to remember—we have not yet experienced for ourselves how long life frames our own cognitive experience. Certainly we can make an attempt to imagine ourselves as older, but that won’t quite get to the client’s own experience.
If the deep past is not up for discussion, where do we begin? In the here and now. Senior clients want to look at today and the future. Now based therapy is thus indicated. Rational Emotive Behavioral Therapy or Cognitive Behavioral Therapy is useful. They focus on what behaviors are currently problematic, how they can be triggered by specific cues, and how response to behavior cues can be changed. CBT and REBT tend to be concrete in identifying problems and specific in identifying targeted behavior for change.