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Older Male Clients: A Neglected Resource

With men over 65 at the greatest risk of suicide, what more can therapists do to support older male clients? As Movember focuses attention on men’s mental health, Brad E. Sachs, founder and director of The Father Center, proposes that focusing on a man’s rich potential role as a father or grandfather can help struggling clients find new purpose and belonging – long after the nest empties.


Ralph Waldo Emerson wrote, ‘As we grow old… the beauty steals inward.’ This is a lovely sentiment, but, unfortunately, it is not only beauty that may take up residence within us as we age. Often, there are feelings of hopelessness and despair that steadily work their way inside of us, as well, leading our senior years to be characterised more by ache than by beauty.

That is one of the main reasons that, globally, older adults have higher suicide rates than other age groups. And, distressingly, the suicide rate for aging men is more than three times higher than it is for aging women. The World Health Organisation reports that suicide represents half of all male violent deaths worldwide, with men over 65 being at the greatest risk.

As clinicians, we are surely aware of why men are more vulnerable to suicide than women are.  Most prominently, traditional male gender roles discourage emotional expression, which makes it challenging for men to reach out and ask for support when they need it. Males are taught from an early age to ‘tough things out’ and repress or deny the psychological vulnerability, distress or anguish that they are experiencing, perceiving it as a sign of weakness rather than an opportunity for growth, healing and burgeoning self-awareness. 

When it comes to older males, a matrix of additional stressors can come into play, including increased social isolation, the death of loved ones (parents, friends, spouses), cognitive slippage, diminishing sexual vitality, physical decline, and retirement and its accompanying loss of professional identity.

So how can we, as therapists, become more effective when it comes to treating men and preventing so many of their lives from terminating so suddenly and so tragically? 

Perhaps the most powerful antidote to suicidal urges is feeling purposeful, discovering and maintaining a sense of meaningful connectedness to others, to oneself, and to the world at large.  When we believe that we belong, we are less prone to being overcome by the inescapable limitations, vicissitudes and decrepitudes that accompany our development beyond midlife.

One very powerful, but too often neglected, way to promote an older man’s belief in his belonging is to focus on his role as a father or grandfather. Over the last several decades we have become increasingly aware of the profoundly important role that fathers play in the lives of their children, the many crucial ways in which they contribute to the wellbeing of their sons and daughters. 

But we have been far less attentive to the role that fathers take on as they grow older and are no longer functioning in a day-to-day role as parents once their family nest empties. Emphasising for men how relevant and necessary they still are to their children, and, if such is the case, to their grandchildren and great-grandchildren, may be one of the most potent ways to remind them of their importance and convince them of their value.

Older fathers and grandfathers serve numerous, and often overlapping, roles in their families, including:

  • mentor and teacher
  • family historian and storyteller
  • nurturer of emotional and physical wellbeing
  • playmate
  • financial subsidiser
  • provider of wisdom and moral support
  • source of guidance and advice

I have repeatedly found that encouraging men who are struggling with a shrinking sense of purpose to broaden and amplify their fatherly and grandfatherly identity as they age is helpful – a psychologically reliable way to inoculate them against being overwhelmed by the indignities associated with senescence, so that they can begin travelling down new and creative developmental pathways.

Our older male patients may find Emerson’s beauty lying quietly within the enduring love that they bequeath to their children and grandchildren. Reminding them of that enduring love may turn out to be the clinical intervention that is most likely to help them to endure.


Brad Sachs

Dr. Brad Sachs is a psychologist, educator, consultant and best-selling author of numerous books for both general and professional readership. He specialises in clinical work with children, adults, couples, and families in Columbia, Maryland, and is also Founder and Director of The Father Center, a program designed to meet the needs of new, expectant, and experienced fathers.

Dr. Sachs is a graduate of Brown University, where he met his wife, Dr. Karen Meckler, a psychiatrist and medical acupuncturist, and together they raised their three (now adult) children and enjoy visits with their grandchildren. His most recent book, The Good Enough Therapist:  Futility, Failure and Forgiveness in Treatment, is published by Routledge. For additional information about Dr. Sachs’s work and writing, see his website: