Sanford Finkel, a psychiatrist, specializes in the psychological problems of the elderly. His interest in the field began 20 years ago when he watched his grandfather slowly deteriorate in a nursing home. In the late `60s he ran one of the first therapy groups for seniors, serving schnapps to his clients, who shared their common problems.
Q-How old are your patients?
A-There`s a wide range, from those in their 60s to my oldest active patient, who is 95. Actually, the question of what is ”old” is an interesting one. Twenty years ago 65 was considered geriatric. Ten years ago we started to divide older people into the ”young old” and the ”old old.” Young old meant 60 to 75; old old was over 75. In recent years we`ve changed the definition again. Now the old old are those over 85, and they are now the most rapidly expanding group in American society.
Q-We`ve all read about Alzheimer`s disease. What are some of the other mental-health problems of older people?
A-Depression is a very common condition. Also, acute confusional states, paranoia, adjustment disorders and anxiety disorders.
Q-Is it very difficult to treat elderly people because they`re more ”set in their ways”?
A-Not really. As a group, I find them more amenable to treatment. Don`t forget, we`re dealing with the survival of the fittest here. These people have lived through innumerable traumas. They`ve survived multiple losses. They`ve demonstrated that they have relatively strong egos and that they can survive and cope with a lot of life`s problems. Many of them are less defensive about treatment. They want to get right down to business.
Q-What is the major concern of the elderly?
A-Dependency. Many of them are much better at giving than receiving. They`ve provided for others all their lives, but when they have to rely on others, they have significant psychological problems. I try to help them accept their dependency, to learn to lean on other people. I say to them:
”You`ve paid your taxes. You`ve done your duty to society. It gives other people gratification to allow them to do things for you.”
Q-Do many of them feel bitter about getting older?
A-It depends on their personalities. People who are narcissistically preoccupied-who live only for their body and their appearance-often have trouble later in life. People who put off for tomorrow the gratification that they should have had today also become bitter because they`re running out of tomorrows. But for many, old age is a time to come to terms with life. Tranquility and wisdom and a sense of maturity can come from looking at life with objectivity over the passage of time.
