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Psychotherapy for persons in and past their seventh decade of life has not been viewed with optimism. The potential patients in this age group are themselves disinterested in psychotherapy. Their hopelessness or contempt for its possibilities is frequently explicable by the nature of their difficulties. The indifference or hostility of family, community agents, physicians and even psychiatrists to what psychiatry may offer aged persons usually stems from the anxiety or resentment aroused by the extreme helplessness as well as the truculence and apparent dearth of resources of their charges. All, including physicians and psychiatrists, justify a pessimistic attitude by emphasizing the profligacy of expending time and effort on patients in whom few years remain for pleasure and profit and whose small strengths promise, at best, small productivity.
Always obtrusive, but too often ignored, in each case is the extraordinary benefit that accrues to younger persons—family, friends and the responsible community—when disordered behavior of an elderly person is meliorated. This practical result alone should suffice to encourage psychiatric effort, as any one can attest who has dealt with the problems of young or middle-aged persons entangled in a web of emotional bondage or realistic burdens with a severely-disturbed aged parent. The challenge that the character disorder, neurosis or psychosis of an aged parent presents to his adult child is often far greater than can be met without special help. Conflicting impulses are common in a society that encourages freedom from parental authority yet prevents, condemns, or renders unwise, removal from parental figures. The physician in our culture, moreover, is bound by a moral responsibility to meliorate where he cannot cure and to ease or comfort where melioration is impossible. Failure to undertake these obligations with the aged is not alone an abandonment of them, it is injurious to the morale of younger persons. Fulfi