Psychotherapy and deaf elderly clients

One of the fastest growing populations in the United States today is that of people over the age of 65, currently defined as elderly (Foos, 2008, p. 3; National Institute on Aging, 2002). Age 65 is generally used to define the term elderly because that age has been associated with mandatory retirement in many occupations (Knight, 1996) and is associated with receiving Medicare benefits. The elderly, just as with many other diverse groups, are considered to be a cultural group of its own (Anderson, 2002, p. 130; Sokolovsky, 1997, pp. 2-4). In addition, all elderly people are members of at least one other "original" cultural group, and membership in elder culture is secondary to the primary cultural identity (Anderson, 2002). It is also one of the few cultural groups that under normal circumstances, everyone will, at least chronologically, eventually become a member. Elderly people are considered to be a vulnerable group because of potential age-related deterioration of the body and mind, their status in society, and potential financial limitations they may face from living on a fixed income (Abeles et al., 1998; Russell, 1999). Making up a small, but significant, part of both the aging and Deaf communities are Deaf elderly individuals, who were either born Deaf or hard of hearing, became deaf at an early age, use American Sign Language (ASL) as their primary means of communication, and benefitted primarily from an education in Deaf programs. This group differs from those born and raised hearing and who later become deaf or hard of hearing due to physical changes in hearing (e.g., presbycusis). These two groups, the elderly deafened and the Deaf elderly, are often mixed together by medical and mental health professionals unfamiliar with Deaf culture. As such, these individuals present a unique challenge to mental health professionals (Feldman, 2005). Professionals must be aware of the specific challenges related to the treatment of Deaf clients in both groups as well as those challenges inherent in providing services to geriatric populations. Even those professionals whose focus of practice is not primarily with an elderly clientele are likely, in the course of professional practice, to be involved directly or indirectly with Deaf elderly people (Pray, 2002).