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With this contribution I want to share the developments occurred during my work as a psychologist in a RSA (nursing home), referring to some interventions that I have conducted. It is possible to identify a line of development within their succession, inherent in the construction of the competence to deal with the specific problems encountered in working with the third and fourth age, in the context of organizations that respond to the demand for care and assistance of elderly people in various ways no longer self-sufficient. Building these skills has not been without its challenges. On the contrary, it proceeded from recognizing how even the psychologist's action, coherently with the culture of a context in which the elderly person rarely speaks, may not be aware of his/her existence. The work of the psychologist runs the risk of eluding the elderly, silencing their presence. The alternative lies in admitting the survival and irreducible vitality of his unconscious emotions; this makes possible to discover their expectations when entering the new life condition and staying in the RSA. In this discussion, I propose the hypothesis that the definition of a peculiar identity of the elderly, different from what is foreseen by the evolutionary schemes prescribed by a life cycle psychology, contributes to the construction of a psychological function. Function that identifies specific intervention requests in the residential context of care for the elderly, and which was able to develop within a specialization course in psychoanalytic psychotherapy. [ABSTRACT FROM AUTHOR]

In recent decades there has been a progressive increase in the elderly population worldwide. Parallel to the lengthening of life expectancy, chronic degenerative diseases have increased in people over 60. By examining several studies on the health of the elderly, it was found that in addition to Alzheimer’s disease and other forms of dementia, depression is the mental illness that frequently occurs in this population. It is often underdiagnosed and untreated and causes psychological, social, and disability malaise. New epidemiological data show the impact of late-life depression in terms of mortality and social isolation. Consequently, the scientific literature underlines the urgency of evidence-based psychotherapeutic protocols in old age. Therefore, the study aims to analyze clinical manifestations of late-life depression, paying attention to the differential diagnosis between depression in old age and dementia. Finally, the present study examines the current protocols used in cognitive-behavioral therapy in late-life depression. [ABSTRACT FROM AUTHOR]

In old age, the most frequently-occurring conditions that involve psychic suffering and that often acquire psychopathological connotations are maladjustment, anxieties and fears, depression and cognitive decline. These are existential and clinical areas that Professor Marcello Cesa-Bianchi has dealt with many times in his long scientific career. His early works include in particular the maladjustment of the elderly detected and analysed in different experiential contexts. Whereas anxieties, fears and depression - in addition to maladjustment - also occur in other periods of life, in old age they acquire specific characteristics. Furthermore, the ageing process involves the risk of the onset of dementia, in its various forms. Cognitive decline - without of course ignoring its clinical manifestations and still unknown etiology - is considered in its multidimensionality and hypercomplexity, highlighting above all the emotional, relational and creative dynamics. [ABSTRACT FROM AUTHOR]

In Italy, more than one million individuals are affected by dementia and there are around three million caregivers, with a major impact at both family and social levels. Prolonged care of these patients induces in their caregivers high levels of stress, anxiety, burden and depressive symptoms. Several studies have recently focussed their attention on the concept of grief and the associated feeling of loss. The progression of the patients' cognitive impoverishment and impairment of social competences causes intense grief in their caregivers, which can be compared to that experienced in the event of a real loss. Here we provide a critical analysis of the theoretical aspects of the concept of pre-death grief in the caregivers of patients with dementia, reviewing literature concerning clinical and intervention studies. [ABSTRACT FROM AUTHOR]

The article informs that the economic and politics intervention has resulted in high frequency of neurodegenerative disorders among the still actively working population. It mentions that a unified diagnostic- therapeutic-rehabilitative process is needed to manage cognitive impairment in working elders. A table is presented which lists the rehabilitation strategies in mild cognitive impairment (MCI) and dementia.