[Psychiatry and psychotherapy of aging]

The competence model is fundamental for the understanding of the aging process. This model does not limit itself to a description of deficits but focusses on the existing skills and capabilities of the person, allowing for age related pecularities. All geropsychiatric interventions start from a geropsychiatric assessment which extends beyond medical diagnosis and an enumeration of findings. This requires interdisciplinary cooperation. Since psychiatric illness in old age has multiple determinants, interventions need to embrace multidimensional approaches on the somatic, psychological and social level. At present, a number of interventions are available for treatment, rehabilitation and nursing care of old people with psychiatric illness. This includes psychotherapeutic interventions, which have proven successful. A reductionists view is therefore not warranted. An appropriate level of care, including rehabilitation or skilled nursing care, for the elderly from a high risk group for psychiatric morbidity or with psychiatric illness already present requires coordination of regional care facilities.