In this paper I would like to present the experience I have had as a sychotherapist, working with a group of elderly patients in an assisted living facility. I have illustrated this experience with four clinical vignettes and the pictures that often come to my mind when working with these patients. I have attempted to explain how death anxiety, along with a massive and overwhelming sense of loss, predominates in this group. I have also endeavoured to show the predominating defences that are used, and what I think should be the role and function of therapists who work with the elderly in an institutional environment.
Key words: anxiety, defences, death, loss, geriatric facility, old age.