In this paper I have focused attention on a particular group of patients who by the very nature of their narcissistic disorder often do not seek help until they are elderly. I have indicated through clinical material the nature of intrapsychic conflicts, a failure to achieve and work through depressive anxieties that interfere with the successful resolution of problems related to mourning; this does not allow for adequate adaptation to ageing and poses problems with regard to the evaluation and prognosis of such patients for psychoanalytic therapy.