In my more than 20 years providing therapy to dementia caregivers, I often hear some version of:  “Around other people they’re pleasant and conversational, but with me they just shut down or get short-tempered. They could treat me differently if they wanted to.” The truth…

For more than 20 years as a Geropsychologist, I’ve received calls from people searching for a therapist for an older loved one — or a colleague looking for a referral. They weren’t asking for anything extraordinary. They wanted someone who understood depression in later life,…

I’ve been providing psychotherapy to older adults for more than 20 years. And one of the things that has never stopped breaking my heart is how often older adults do not get the mental health care they need, resulting in unnecessary suffering. Depression that goes…

In the field of geropsychology, it is well known that depression is both a risk factor for and an early symptom of dementia. One of the most consistently missed diagnoses I see in clinical practice with older adults is depression in the context of dementia.…

I think about a therapist who had been meeting with an older client every Tuesday for nearly a year. At first, the changes were easy to explain away: a missed appointment here, a repeated story there, a moment of losing track in the middle of…

A family member calls asking you to see their older loved one who’s living with dementia. In psychotherapy with adults, that call raises red flags. Who is the client? Who holds the decision-making authority? Where do the boundaries fall? But with older adults navigating life-altering…

A clinician in my Mental Health + Aging Certificate program recently asked a question. He was reflecting on the opening module — the one where I lay the foundation for who we are providing therapy for, where I explore intersecting identities, share important statistics, and…

“This is probably the last few chapters of her life. And I made it worse. I lied to her and I betrayed her and I don’t know if I can forgive myself.” This is what a caregiver shared with me in therapy. She lamented over…

“I feel like I’m doing time for a crime I never committed.” That’s what one of my older patients said to me in our very first session after he was moved unexpectedly from his home into assisted living. He wasn’t exaggerating. He wasn’t being dramatic.…

Imagine waking up every day not knowing whether to grieve or to hope. Whether to set a place at the table or quietly put the extra plate away. Whether to say “is” or “was.” This is the territory of ambiguous loss — and it is,…

I want you to picture someone I’ll call Margaret. She’s 74 years old, sharp-witted, funny, and deeply engaged in her community. But lately, she’s been misplacing her keys more than usual. She blanked on a neighbor’s name she’s known for twenty years. She missed a…

Imagine sitting across from an 82-year-old woman who has survived the death of her husband, two of her children, and now — a diagnosis that threatens to reshape everything she thought her final years would look like. She has never spoken to a therapist before.…