What makes therapy with older adults different

These aren't normal parts of ageing, but they are common and treatable. Depression in older adults often presents differently from depression in younger people - it may manifest as physical aches and pains, memory difficulties, irritability, or loss of interest in previously enjoyed activities. Anxiety can show up as excessive worry about health, catastrophic thinking, or physical symptoms like chest tightness or shortness of breath. These conditions can be triggered by life changes, chronic health conditions, medication side effects, or cumulative losses. We work with the particular ways depression and anxiety manifest in older adults, addressing both the practical and existential dimensions of these experiences.

Losing partners, friends, siblings, and sometimes even adult children creates layers of grief that can feel overwhelming. The losses accumulate - each bereavement carries not only its own weight but also echoes of previous losses. You may find yourself grieving not just people, but roles, independence, health, or the life you imagined for this stage. Disenfranchised grief - loss that isn't socially recognised, such as the death of a former partner, a close friend, or a pet - can be especially isolating. We provide space to honour these losses in all their complexity whilst finding ways to continue living with meaning and connection.

Social circles often shrink in later life through bereavement, mobility challenges, retirement, or adult children moving away. Loneliness isn't simply being alone - it's the painful feeling of disconnection and the sense that meaningful relationships are missing from your life. Chronic loneliness can have profound effects on mental and physical health, increasing risks of depression, cognitive decline, and cardiovascular disease. Yet rebuilding social connections in later life can feel daunting. Therapy itself offers a consistent, meaningful connection whilst we explore what's making it difficult to connect with others and find practical ways to rebuild social relationships that feel authentic to you.

Chronic illness, pain, reduced mobility, hearing or vision loss, or cognitive changes can feel like profound betrayals of the body you've lived in for decades. These changes affect not just what you can do, but how you see yourself and your place in the world. You may grieve your former physical capabilities whilst simultaneously trying to adapt to new limitations. The fear of further decline or dependency can create constant anxiety. We help you find ways to live with these realities - processing the grief and anger they bring - without losing your sense of self or agency.

Long-term relationships face unique challenges in later life that can strain even the strongest partnerships. Adapting to retirement means renegotiating daily routines and finding new ways to occupy time together after years of separate working lives. Health changes may require one partner to take on caregiving responsibilities, fundamentally altering the balance of the relationship. Sexual changes or loss of physical intimacy can create distance and unspoken resentment. After decades together, couples may find they've grown apart or fallen into rigid patterns that no longer serve them. We offer couples therapy to help partners communicate more effectively, address longstanding patterns with honesty, rediscover each other beyond caretaking or functional roles, and find renewed intimacy and understanding. Even long-term relationships can change and deepen.

Sexual intimacy doesn't end with age, but it does change - and those changes can be distressing and confusing. You might be experiencing changes in desire or arousal, erectile difficulties, vaginal dryness or pain during sex, difficulty reaching orgasm, or body image concerns that make intimacy feel impossible. Health conditions like diabetes, cardiovascular disease, or prostate issues can affect sexual function, as can medications for depression, blood pressure, or other conditions. You may be navigating sexuality after the loss of a partner, uncertain how to approach intimacy with someone new. Or perhaps you're in a long-term relationship where sex has become a source of tension or avoidance rather than connection. We provide a safe, non-judgemental space to explore these issues, whether individually or as a couple. These concerns are valid and treatable, and deserve sensitive, specialist support. Addressing sexual wellbeing isn't frivolous - it's integral to quality of life, sense of self, and relationship satisfaction.

Family dynamics in later life can be particularly complex and painful. Adult children may be making decisions about your care without consulting you, or you may feel invisible in their lives. Grandparenting can bring joy but also unexpected grief if access is limited or relationships are strained. You might be caring for your own ageing parents whilst managing your own health concerns. Long-buried sibling rivalries or family conflicts can resurface, particularly around caregiving responsibilities or inheritance. Some older adults face estrangement from adult children - a particularly painful loss that often goes unacknowledged. We help you understand these dynamics, set boundaries where necessary, process hurt and disappointment, grieve relationships that cannot be what you hoped, and find ways forward that honour your needs and dignity.

Later life naturally brings reflection - looking back over the life you've lived, the choices you made, the relationships you've had. This review can be enriching, but it can also surface regrets, guilt, shame, or a sense of "what if." You might be grappling with things left unsaid, relationships that ended badly, career paths not taken, or ways you feel you've failed as a parent, partner, or person. Some experiences from decades ago may resurface with unexpected intensity. We support you in making peace with your past where possible, addressing regrets with honesty and self-compassion, finding resolution or acceptance where circumstances cannot be changed, and integrating all of your experiences - the painful and the joyful - into a coherent sense of self and life story.