In-home talk therapy for seniors on the rise on Long Island

For therapist Samantha Quinn, working with clients in their home is not just a benefit for those who can't travel. It can also help her understand them on a deeper level.

Quinn, a Smithtown-based licensed clinical social worker who specializes in in-home therapy for seniors, recalled one time when during a home visit a blind client showed off a needlepoint pillow she had crafted.

"It opened the door for a conversation about how she was struggling with the fact that she can no longer do her needlepoint due to her blindness," said Quinn, who began offering in-home therapy earlier this year and now has 25 clients. "In-home therapy is more intimate, like a heart-to-heart conversation." Quinn said she has had to hire two more clinicians since she began offering in-home counseling.

For older adults who have difficulty getting to a therapist's office, local counseling providers say talk therapy that meets them where they are is becoming more common on Long Island. Whether it’s counseling done face-to-face, virtually via Zoom or on the telephone, therapy at home works for seniors who may not be able to travel or find it difficult to do so. 

Seniors are less likely to participate in talk therapy than other age ranges, data shows. At-home therapy can lower the barrier for seeking help.

"Some people don’t want to go to a formal setting or ‘go out’ to see a counselor," said Susanna Caputi, a licensed mental health counselor with Family & Children’s Association who does in-home therapy with seniors. "This bridges the gap."

Just 7.5% of adults aged 65-74 and 5% of those 75 and older engaged in talk therapy, compared with 18.7% of those 45-64, according to national 2024 data from the Centers for Disease Control and Prevention in Atlanta.

"There is no single reason they are less likely to seek counseling, but some obstacles are practical — cost, health problems, transportation and difficulty accessing services can all make getting help more complicated," said Lee Ann Rawlins Williams, a clinical assistant professor and program director of Rehabilitation and Human Services at the University of North Dakota in Grand Forks who studies aging and mental health.

Russell Chertok, founder and executive director of Visiting Counselors of New York in Melville, pointed to other reasons. "Some seniors may still view mental health treatment as stigmatizing or see symptoms such as depression, anxiety as a normal part of aging," he said.

But talk therapy is very much needed for older age groups, experts say.

"From our experience, we can say that across the board in all of our programs we are seeing an increase in seniors suffering from depression and anxiety and seniors with serious mental health challenges," said Lisa Stern, assistant vice president of Senior & Adult Services at the Family & Children’s Association in Garden City. FCA’s Linkage program serves about 125 seniors a year, with about 80% of them receiving in-home therapy, Caputi said.

According to the World Health Organization, about 15% of adults aged 70 and over live with a "mental disorder." Health problems, chronic pain, financial issues and the loss of loved ones can all contribute to depression and anxiety.

"Isolation is a big thing," Quinn said. "They have lost family, spouses, friends. Their circle shrinks, their kids are busy. They feel like they are a burden to their family."

Much like therapy in a traditional setting, in-home therapy is typically 45- to 60-minute a session, weekly, biweekly, or however frequently prescribed. It can be covered by Medicare, as well as private insurers.

'It's OK to talk'

Part of the reason providers are seeing more seniors turn to in-home therapy is that there is less of a stigma attached to therapy than a generation or two ago.  

"More seniors are realizing it’s OK to talk, and it doesn’t have to be so clinical," Quinn said.

For those who might feel embarrassed about their living situation, Caputi said they shouldn't be.

"I’ve had cases where I go in the home, and it is messy, the person is a hoarder, but I don’t cast judgment," she said. "That’s the reason for me to coming in, to help, to make things better, not to judge."

No excuse not to go

A 93-year-old woman from Ridge, who asked not to be identified because she feels vulnerable as an elderly woman living alone, said she became depressed after losing her vision to glaucoma and macular degeneration. She said in-home talk therapy is working. "I look forward to her coming every week," the woman said of her therapist. "On a scale of 1 to 10, I’m feeling like an 8 now."

Online therapy can be a big help, as well.

Patricia Raifer remembers a time when leaving the house felt like an accomplishment. The 61-year-old Plainview retiree, who has anxiety and depression, was seeing a therapist 45 minutes from her home. Sometimes making the drive was an impediment, and if she wasn't feeling motivated, she would cancel.

"Back then just to get out of bed was a lot. I didn’t leave the house a lot," said Raifer.

Then during the pandemic she began doing group therapy via Zoom. She then switched to online individual therapy. It's been helping.

"There have been times where I didn’t feel like doing therapy, but I log on and five minutes later I’m OK," Raifer said. "Because I don’t have to go anywhere, and am comfortable where I am, I have no excuse for not doing therapy."