After her husband died two years ago, Miriam Zatinsky, a retired social worker who is now 87, moved into an independent living facility at Miami Jewish Health Systems. It was a difficult transition to make late in life.
“It was really strange to me, and I couldn’t seem to make any friends here,” Ms. Zatinsky said. “I really couldn’t find my way. I was having a terrible time.”
The medical director for mental health at the facility, Dr. Marc E. Agronin, a geriatric psychiatrist and the author of “How We Age,” told her that her problems were not unusual for someone in her situation, and encouraged her to make some friends. He prescribed Xanax to help with anxiety, which she said she rarely takes, and he put her in touch with a social worker, Shyla Ford, whom Ms. Zatinsky saw once a week until Ms. Ford moved (Ms. Zatinsky now has a new social worker she talks to). They strategized on how she could reach out. And slowly, she did.
“Sitting at the table for dinner, you talk to people,” said Ms. Zatinsky, who has become president of her building.
Typically, 15 to 20 sessions of talk therapy are enough to help an older patient, unless he or she is struggling with a lifetime’s worth of significant problems. Still, even long-term issues can be overcome.
After a debilitating depression in which she spent three months unable to get out of bed, Judita Grosz, 69, of Pembroke Pines, Fla., decided to see Dr. Agronin, who prescribed medication. (She also tried group therapy but didn’t like it.) He also practiced some cognitive behavioral techniques with her — for instance, requiring her to get dressed every day for a minimum of 15 minutes.
Eventually, she began to feel better. “I learned to adjust my thinking, and I don’t get as anxious as I used to,” said Ms. Grosz, who has since begun making and selling jewelry. “I found out at this age that I am artistic and creative and innovative and smart. I just woke up to the fact that I have a mind of my own. Talk about a late bloomer.”
Dr. Agronin, who still meets with Ms. Grosz monthly, said, “You might not be able to gain a magical insight and wrap up their entire life in therapy, but you might be able to accomplish one or two small but meaningful goals.”
Sometimes, what older patients really need is help putting a lifetime in perspective.
“Things can be seen differently from the perspective of old age that relieve some guilt and challenge assumptions that you’ve had for decades,” Dr. Abrams said. “ ‘Maybe it wasn’t too terrible after all; maybe I shouldn’t blame myself.’ Maybe some of your worst mistakes weren’t so egregious, and maybe there were unavoidable circumstances you couldn’t control.”
Mr. Tolkin still stops by Dr. Abrams’s office for a monthly checkup.
“Everybody has a certain amount of heartache in life — it’s how you handle the heartache that is the essential core of your life,” Mr. Tolkin said. “I found that my attitude was important, and I had to reinforce positive things all the time.”
He said he wishes he had tried therapy years ago. But he adds: “I can’t go back. I can only go forward.”