Working with older people presents many challenges, but to what extent should one expect older people to change their lifestyles as a result of therapy? With what changes in society do therapists need to acquaint themselves in order to have realistic expectations of this patient group? Before embarking upon therapy with older people, many considerations need to be taken into account, not least of which is an understanding of the realities facing the individuals with whom the therapist may be working.
Many authoritative articles have been written about the process of working therapeutically with older people and it is often stated that knowledge of normal ageing is necessary for working with that age group. However, it is rare for guidance to be given on the aspects of knowledge of the ageing process that would be helpful to the psychotherapeutic process. This chapter aims to orient the therapist to aspects of ageing that are important and to provide affirmation of existing knowledge of good practice for the experienced clinician.