Sarah Woodroff reflects on the meaning of working with older clients.

“Never grow old dear”, is a phrase I have heard from lots of older people. I worked as a health care assistant in a residential care home when I was in my early twenties, and it was here that I first faced the difficulties that ageing can bring: loss of physical and mental abilities, loss of health, friends, partners, social status, and freedom to name a few. In a society where youth and beauty are aspired to above experience and wisdom, devaluing and isolation can often be the experience of our elderly. It can be uncomfortable to sit with this; existential anxieties of our own mortality and powerlessness can be triggered. “Never grow old”: we can grow old or die young. Neither option is appealing.

   Yalom (2013) tells us that these existential anxieties can be as intolerable as “staring at the sun”. Aged 21, I coped by eating all the superfoods I could stomach, hoping that the antioxidants contained in blueberries and sweet potatoes would be the magical elixir humanity has spent millennia hunting for. Of course, they weren’t – there’s no such thing, and we will all grow old. Hopefully.   I think that these anxieties can be the root cause for reluctance in some therapists to work with this client group. I think that it is understandable, particularly in the beginning of practice when, perhaps, they have not been worked through in personal therapy. However, our BACP (2018) ethical framework tells us to consider the principles of “courage”, “fairness”, “resilience” and “beneficence”. If we face these fears and work through them, not only are we working ethically for our clients, but also for ourselves. Yalom tells us to face our anxieties so we can live a full life. As therapists we can help our clients do this, and possibly, in turn they help us. 

 I have worked with older people in various capacities for twenty years and can say with all honesty that I have found it to be rewarding and healing both for the older people I have been with, and for myself. Yes, ageing brings pain and sorrow, but it also comes with beauty and new possibilities. I have sat with clients as they work with their grief, find a new place within their social network and in society, find a new love and a new identity. I have been thoroughly entertained with lifetime stories and new hopes for the future. I would like to share a journey I had with an older client to illustrate how true this is:


All identifying details have been changed to protect client’s identity. Sheila (82), came to counselling following the death of a loved one she had spent the past 20 years caring for. When I met her, she was despondent. She felt there was no point to life; she had lost the person she had built her life around and all that was left was death. She hoped that would come soon. Sheila didn’t contact friends through fear of “being a burden”. She wasn’t eating, sleeping, or attending to her personal care.

At first, this felt overwhelming; her grief was immense, and her sense of purpose seemed non-existent. How could I begin to help her? I remembered what brought me to this profession – the belief in the healing power of being truly listened to, heard, and understood. This is where we started. Sheila told me her story, from early childhood, all the way through to the present day. She had had a rich and varied life, full of ups and downs, and we laughed and cried over the weeks and months we worked together. We did grief work – she told stories and shared photos of her loved one. She put a picture frame in the kitchen where she talked to them while she cooked – she was eating again. Sheila joined a walking group and spent days out with her grandson. She regained her sense of purpose. Her loved one stayed with her, in a new way, and she found new connections with friends and family.

Sheila told me that a perk of old age is the permission to go slower “I spend hours watching the birds, it’s so peaceful”. Therapy helped Sheila move through her grief and find a new purpose in life. Sheila helped me find the permission to slow down, I think of her when I watch the birds in my own garden, and feel the peace Sheila described. 

Working closely with older clients has helped me to embrace and look forward to my own old age and celebrate theirs. Now I reach for blueberries, not in desperation to hold onto remnants of my younger self, but because they are delicious!


BACP (2018). Ethical Framework For The Counselling Professions. Available at: Yalom, I., 2013. Staring at the sun. San Francisco, Calif.: Jossey-Bass.