Though it is generally acknowledged that older adults are underserved in the area of mental health services, the impact of ageist stereotypes on mental health diagnosis and access to care, and on the provision of psychotherapy to older adults, has not been extensively studied. This chapter reviews the sparse literature on ageism and mental health services with the goals of examining current practice related to the assessment of mental health problems and barriers to optimal therapy of older adults from the social perspective of ageism. The chapter begins with a review of literature pertaining to attitudes of mental health clinicians towards psychotherapy of older adults, and focuses on possible contributing factors to the development of ageist attitudes among clinicians. Subsequently, we discuss older adults’ negative attitudes toward ageing, psychiatric diagnosis and psychotherapy, which may affect patients’ interpersonal encounters with a psychotherapist. We also address challenges and problems in the assessment and diagnosis of older mental health patients, and raise the possibility that ageist attitudes may be responsible for some of these issues. Finally, we discuss common difficulties in providing therapy to older adults with mental health problems and review different therapy approaches with older adults. Here again, we discuss the possibility that ageist attitudes might play a role in difficulties with the adaptation of these therapeutic methods for older adults. The chapter concludes with a discussion of possible prevention strategies to address ageist attitudes in mental health settings and makes recommendations regarding future research in this understudied area.

Objectives: Subjective age refers to how young or old people experience themselves to be, while subjective distance-to-death reflects how far or close they experience themselves to be from their death. The present study examined whether subjective age and subjective distance-to-death interact in predicting psychological distress. Method: A sample of 1073 community-dwelling older adults at the age range of 50–86 (M = 58.1, SD = 5.3) evaluated their subjective age, subjective distance-to-death, psychological distress, and rated several measures of physical health. Results: After controlling for background characteristics and physical health indices, perceiving death as far and reporting younger subjective age predicted lower psychological distress. The combination of feeling close to death and older subjective age was related to the highest ratings of psychological distress. Moreover, the effect of subjective distance-to-death on psychological distress was mitigated by younger subjective age. Conclusion: The findings underscore the importance of an integrative view of two time perspectives – one that focuses on time since birth and another that concerns time left till death – to psychological distress of older adults.

We evaluated the associations between loneliness and subjective appraisals of marital relationship as well as reciprocal associations of loneliness in married men and women. The Health and Retirement Study is a national survey of older adults over the age of 50, residing in the US. This study is based on a paper and pencil questionnaire administered in the year 2006. Overall, 2723 couples completed this questionnaire. Loneliness was evaluated using the three-item version of the Revised University of California Los Angeles Loneliness Scale. A non-recursive path analysis was conducted. The model suggested that subjective appraisals of the relationship with spouse play a major role in one's sense of loneliness. In addition, loneliness in men and women shares reciprocal associations. The model explained 24% and 29% of the variability in loneliness reported by married men and women, respectively. Results indicate that capitalizing and enhancing one's social life might also be beneficial for his or her partner. Any intervention to alleviate loneliness in married couples has to take into consideration their perceived marital relationship as well as the reciprocal associations of loneliness in married men and women.

This paper reviews the literature on the long-term effects of the Holocaust on survivors, their offspring, and their grandchildren. Two major conclusions are drawn. First, the functioning of these three generations is best characterized by general resilience along with specific vulnerabilities. Thus, although most survivors and their descendents lead normal lives, specific vulnerabilities may appear under adverse situations and are interwoven in the family dynamics. Second, the aging process not only presents increasing challenges to the survivors themselves but also reshapes the intergenerational relations within their families.