Why older adults avoid therapy — and how to help them open up

(Aging Untold) — For some older adults, the word “therapy” carries a stigma rooted in a generation that was taught to stay quiet and keep going.

Gerontologist “Sam” Cradduck says that silence has a cost and the Aging Untold experts have practical, low-pressure ways to help older loved ones start talking.

A generation taught to hide it

“Our age community was raised in a time when mental health was not something that we talked about,” Cradduck said. “Mental health was something that was hidden underneath the rug.”

Cradduck said that stigma meant asking for help was often seen as shameful.

“It was looked at with such distaste that for an aged person to say, ‘I need help,’ or ‘I would like to talk to someone’ — and that’s why there’s so much depression, I think, in our aged community,” Cradduck said.

She connected that silence directly to unresolved pain.

“When you haven’t been able to deal with all of the trauma that life has given you and you haven’t processed through, then there’s such a heavy weight on you,” Cradduck said. “Psychotherapy is absolutely an essential part of just being a human being, I think.”

“Survival is not healing”

Older generations were conditioned to push through hardship rather than confront it, Dr. Rhea Rogers, a board-certified physician, said.

“I learned how to survive. That’s the older generation — they were always taught they were very stoic and they survive, but survival’s not healing,” Rogers said. “So they never really had a chance to really even heal or even to recognize, do they even know they’re depressed?”

Rogers added that depression in older adults doesn’t always look like sadness.

“It presents so different. It’s not sadness. They may be irritable. They may just feel like they’re fluttered, you know, or just loss of desire or motivation,” Rogers said. “I don’t think they recognize that they’re depressed.”

Reframing therapy as “education”

Aging expert Amy O’Rourke said the word “therapy” itself can shut the conversation down before it starts — so she uses different language.

“When I’ve worked with clients that hear therapy and you can just see their eyes are like, no, no, no, I just don’t call it therapy,” O’Rourke said. “I say education. Let’s take a class, let’s buy a book just to get them kind of initiated into the idea that maybe talking would be helpful.”

She described one example of meeting a client where they already were.

“I had one Catholic client and I said, ‘Why don’t you go to confession?’ And he did,” O’Rourke said. “And in that tradition, he got it all out with the priest, and he felt better. And then he was open to going to therapy. It was the thing that just triggered him, so be open to using anything just to get that motion going.”

Friends, clubs and community can help too

Cradduck said licensed therapy isn’t the only path to processing grief and life’s heaviness.

“You don’t have to be a licensed therapist to be a good friend and lend an ear. Most of us have some good advice we can give,” Cradduck said. “But this is the bootstrapped generation — you were told you had to pull your bootstraps up, you had to keep going. And they were left suffering.”

Aging well coach Katherine Ambrose pointed to group settings as another outlet.

“Even like Bible studies, book clubs — you know, where you can have discussions,” Ambrose said. “I have people around the country, they’re doing downsizing clubs, and people are really processing all this stuff, all the grief, all the heaviness.”

Ambrose said those groups often lead to deeper conversations than expected.

“They’re talking about the challenges they have communicating with their spouse or adult children, or with the medical episodes that they’ve had. So it’s very cathartic,” she said.

A Medicare benefit many don’t know about

O’Rourke also flagged a federal resource available to older adults seeking mental health support.

“The other resource that I would want people to know about is Medicare. Go to cms.gov. Medicare covers mental health help,” O’Rourke said.

Hospice is another resource, O’Rourke said.

“And if you’ve been involved in losing someone and you’ve had hospice services, you can get help with that grief for 12 months after death,” she said.

Resource

Services & programs Medicare covers

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