Introduction

In the previous section of this book we hope to have laid the ground for a move away from a purely biological view of ageing. While it is undoubtedly true that older age brings with it biological changes that can affect physical and mental abilities, to overemphasise these at the expense of a more developmental psychological approach is ageist and likely to provide a formulation of an individual’s problems that is ultimately limited. While adolescents are expected to suffer from ‘identity crisis’, emotionality and challenging behaviours, similar difficulties in older people struggling to adapt to the changes and challenges of later life are often described in biological rather than psychological terms. Cognitive impairment, cerebro-vascular disease, dementia and ‘reactive’ depression can provide blanket ‘organic’ labels that encourage no further exploration of possible underlying psychological issues. It is rarely all ‘organic’ or all ‘psychological’. The key to greater understanding comes through an empathic description of the interaction between the life events and losses confronting an individual and the personality and coping structures that have got the person to this point in their life.