Getting older brings real changes. Retirement, a spouse's illness or death, children living in another city, a body that does less than it used to. Feeling low for a while is understandable. But long-lasting sadness, worry or withdrawal is not a normal part of ageing, and it often gets better with the right support. This page is for older adults and for the sons, daughters and spouses who are worried about them.
Signs an elderly parent may need more than family support
Older people often do not say "I am depressed". They say "I am tired", "my knees hurt" or "what is left for me now". Look out for changes like these, especially if several have lasted more than two weeks:
- Sleeping much more or much less than before, or waking very early and lying awake.
- Losing interest in things they used to enjoy: the morning walk, puja, a favourite serial, friends, grandchildren's news.
- Eating less, skipping meals or losing weight.
- Saying they are a burden, that life has no use now, or talking about death more than usual.
- Being more irritable, restless or anxious, or worrying again and again about money, health or the family.
- Many aches, tiredness or stomach complaints that doctors cannot fully explain.
- Not answering calls, avoiding relatives, staying in one room.
- New forgetfulness or confusion (see the memory section below).
- Taking more sleeping tablets than prescribed, or drinking more alcohol.
These signs do not prove anything on their own. They are a reason to have a gentle conversation, and to involve a professional if things do not improve.
What counselling for older adults looks like
Counselling is a private, regular conversation with a trained professional. For older adults it usually moves at a slower pace, with plenty of respect for their life experience. Common ways of working include:
- Talking about loss and change. Retirement, widowhood, moving into a son's or daughter's home, or giving up driving can all shake a person's sense of who they are.
- Cognitive behavioural therapy (CBT). In plain words: noticing thoughts like "I am useless now" and checking whether they are really true, then trying small steps that test them.
- Planning small daily activities. Low mood makes people do less, and doing less deepens low mood. Adding one or two small, meaningful things each day helps break that cycle. This is sometimes called behavioural activation.
- Problem-solving. Breaking a big worry, such as pension paperwork or a family dispute about property, into steps that feel possible.
- Looking back over life. Talking through one's life story, its good parts and its regrets, can bring a sense of meaning and peace.
- Support with grief. See our page on grief counselling if your parent has lost a husband, wife, sibling or close friend.
Counsellor, psychiatrist or neurologist: who should your parent see?
| What you are noticing | Who to start with |
|---|---|
| Low mood, loneliness, worry, grief, family tension | A counsellor or psychologist (talking therapy) |
| Severe low mood, not eating, not sleeping for days, hearing or seeing things others do not, talk of ending life, or already taking medicine for mental health | A psychiatrist, a medical doctor for mental health |
| New memory loss, getting lost, repeating the same questions, trouble with money or tasks they managed before | A neurologist or psychiatrist for a memory check, plus their family doctor for blood tests |
| Sudden confusion over hours or a few days, a fall with a head injury, weakness on one side, slurred speech | An emergency: call 112 |
Looking for a geriatric psychiatrist online? A geriatric psychiatrist is a psychiatrist who focuses on older adults. Very few are listed as a separate specialty, but many psychiatrists see older patients regularly. On Mindara you can browse psychiatrists by language and read on each profile whether they work with older adults. Older people often take several medicines, so a psychiatrist will check new treatment against everything else they take. Medicines are always the doctor's decision: never stop or change medicine without the doctor.
When to see a neurologist about memory
Some forgetfulness, like misplacing glasses, is common with age. It is worth seeing a doctor if your parent keeps repeating the same question, forgets recent conversations, gets lost on familiar roads, leaves the gas on, or struggles with money or medicines they handled well before.
Memory problems do not always mean dementia. The NHS (UK) lists depression, anxiety, infections, an underactive thyroid and side effects of some medicines as other possible causes, which is why a doctor usually starts with a check-up and blood tests. An online visit with a neurologist or psychiatrist can cover the history, review reports and plan next steps. Brain scans and detailed memory tests need a clinic visit. Our checklist, Is it depression or dementia?, helps you note what you have seen. If you are already caring for someone with memory loss, see support for dementia caregivers.
How to get your parents to try therapy
Many older Indians grew up thinking counselling is only for "mad" people, or that family problems should stay inside the family. A few things often help:
- Use their words, not labels. "Someone to talk to about your sleep" or "about missing Mummy" is easier to accept than "therapy for depression".
- Say what you have noticed, kindly. "You have not gone for your walk in weeks, and you sound tired on the phone. I am worried."
- Offer one conversation, not a commitment. Many providers offer a free first session of 15 or 30 minutes, which makes it easy to "just try once".
- Let them choose. Language, a man or a woman, an older or younger provider. Feeling in control matters.
- Bring in someone they trust. A family doctor, a sibling or an old friend can say what you cannot.
- Accept a "no" for now. Pushing too hard can backfire. Try again in a few weeks, and keep the door open.
If you live in another city or abroad, you can still help: go through the booking together on a video call, and check in with them after the session.
How a family member can join the first session
- Set up an account in your parent's name, with their phone number or email, so their sessions and messages stay private to them.
- Choose a provider together. Check language, fee, whether they offer audio calls, and whether they offer a free first session.
- Prepare the device. Charge the phone or tablet, increase the font size, test the sound, and keep reading glasses, hearing aids and a list of medicines nearby.
- Join for the first few minutes. With your parent's agreement, sit beside them to help with the call, introduce them and say briefly what worries you.
- Then step out. Your parent needs space to speak freely. The provider may invite you back at the end to agree on next steps.
Some providers also offer a family session, where up to three adults each get their own invitation to the same video or audio call. This can help when the family wants to work through something together, such as a move or sharing care. Whatever your parent says in their own sessions stays confidential, except where someone's safety is at risk.
Audio calls, language and other practical things
- No camera needed. Many providers offer audio calls, which feel much like a phone call. This suits parents who are shy on video or have a slow internet connection.
- Their own language. People open up more easily in the language they think in. Filter providers by language, for example Hindi-speaking therapists, and look for Punjabi, Bengali, Tamil and others on the provider cards.
- Hearing and eyesight. Ask the provider to speak slowly or repeat things. A tablet or laptop is easier than a small phone screen.
- Time of day. Many older people feel sharper in the morning. Choose a slot when they are rested and the house is quiet.
How many sessions are usually needed?
It varies a lot. Some people feel steadier after a handful of sessions focused on one worry. For low mood, grief or a big life change, many people meet weekly or every two weeks for a few months. The provider will review progress with your parent along the way, and they can stop or pause at any time.
Cost and free help
Each provider sets their own fee, and you can see current fees and languages in the box above and on every provider's card. Our page on what therapy costs in India explains how fees compare. Free public help is also available:
- Tele-MANAS: 14416 or 1-800-891-4416. The Government of India's free mental health helpline, open 24×7, in many Indian languages.
- Elderline: 14567. The national helpline for senior citizens, run with the Ministry of Social Justice and Empowerment, open 8am to 8pm every day. It offers information, guidance, emotional support and on-the-ground help in cases of abuse or neglect.
Loneliness is a common reason for low mood in later life. Our article on loneliness in old age has practical ideas for families.
When to get urgent help
Call 112 straight away if your parent talks about ending their life and has a plan, has stopped eating or drinking, becomes suddenly confused, has a fall with a head injury, or shows signs of a stroke such as a drooping face, a weak arm or slurred speech. For urgent emotional support at any hour, call Tele-MANAS on 14416. Do not wait for a booked session in an emergency.
