People are living longer, reshaping what it means to grow old.

By the late 2060s, an estimated 2.5 billion people worldwide will be age 60 or older – more than the number of people under 18. The population age 80 and older is expected to grow even faster, more than tripling between 2023 and 2060 to about 545 million.

Living longer means spending more years navigating the changes that can accompany later life. Those changes can raise questions and concerns that people may explore in counseling or therapy settings. Yet older adults are far less likely than younger adults to receive counseling or therapy.

I study aging, disability and mental health, and I am interested in how counseling can better serve the needs of people later in life. In my view, the counseling gap for older adults often reflects outdated notions of aging and of what counseling can offer.

A comment from a 79-year-old acquaintance helped me put this into perspective. After accompanying a family member to a counseling session where much of the conversation focused on aging and death, he reflected that older adults need opportunities to talk about more than dying. They also need someone willing to listen to them talk about living, along with the changes they are navigating, the decisions they are making and what matters to them now.

The role of counseling in older adulthood is broader than addressing illness, loss and bereavement. These are important concerns, but counseling can also help people navigate changes in work, health, abilities, relationships, independence and identity, and consider what comes next.

Why some older adults don’t seek help

According to national data from 2024, 7.5% of adults ages 65 to 74 and 5% of adults 75 and older received counseling or therapy from a mental health professional – compared with 20.2% of adults ages........

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