[The problem of dying in geriatric psychiatry]

The article attempts to describe dying as a clinically important phenomenon in gerontopsychiatry. This description is based on 1. statistical data collected in a department of gerontopsychiatry, 2. a summing-up of a few essential aspects of research on dying, and 3. several case reports. These three approaches lead to the result that the problem of dying is in many cases connected with phenomena which must be described in terms of gerontopsychiatry. The patients express the threat of death, which they experience as a loss of identity, by means of images based on highly individual personal experience. Hence, it is suggested that such psychotic images should be interpreted against the background of the individual's life history and not symbolically or psychoanalytically. From a sociological point of view, gerontopsychiatry seems to offer suitable means for eliminating the mental conflicts which assume a threatening aspect for most dying persons (a large proportion of them die in a general hospital, but this environment in itself does not offer sufficient relieving or calming factors; it is here where gerontopsychiatry must step in.