ABSTRACT
Clinicians who work with declining elderly patients or clients generally mute their expectations for therapeutic success and foresee a slow pace towards even limited goals. Such patients and clients usually offer no dramatic rewards. When additionally these patients fail to cooperate with our efforts to help them, we may have the set-up for a psychological wrestling match as, to mix metaphors, they drag their feet down the therapeutic path. Their psychological motivations for failing to cooperate need to be seriously considered when we undertake to serve or treat these troubling patients. Voluntary aged patients, almost as often as the involuntary, seem to evade or sabotage our treatment efforts. Why this should be has become of increasing interest to clinicians, practitioners, therapists. (The terms for these professionals will be used interchangeably, as with patient and client.)
