Psychiatrists have learned a great deal about treating the aged patient. Many victims of 'senile decay' may respond to psychiatric and sociological therapy However, hospitalizing such patients is risky; the separation produced by hospitalization may be a threat to survival. The presence of a neurosis or psychosis may act as a defense against the dementing forces that surround the patient. The ability to act as a schizophrenic or as a depressed patient indicates that some potentials for further living must survive. We should consider carefully the wisdom of removing a depressive reaction in an aged patient by electroshock. In so doing we may be breaking down the last defense against a senile psychosis. Loss of motivation and loss of reason for living are part of the pathology of senility. The feelings of not belonging and of being excluded are strikingly parallel to the progression and intensity of the associated organic changes. Much can be done by psychological and sociological means to aid the senile, although little can be done about the organic process.