The purpose of this study is to discern the relevant and effective components of existential and process-work approaches to the clinical treatment of elderly clients with dementia. This study explores how these specific humanistic and transpersonal approaches to this population's presenting concerns represent unique alternatives to the mainstream medical model of dementia treatment that pejoratively frames dementia as a mental illness. Ten therapist interns at two of Pacific Institute's assisted living facilities in San Francisco, CA, were interviewed using open-ended questions designed to elicit detailed accounts of their clinical work using these two therapeutic modalities. The interview transcripts were coded using a qualitative thematic analysis methodology and computer software assistance to identify prominent factors that influenced the therapy, including therapist attitudes, embodiments, clinical conceptualizations, interventions, and impediments to effective treatment. These research results systematically thematize the prominent aspects of existential and process-work approaches in working with older people with mild to advanced symptoms of dementia. It is hoped that this study will inform further exploration of these effective therapeutic modalities in diverse clinical populations and settings.

It is hardly a novel observation that our modern Western culture has drifted into a state of apathy, verging on outright denial, concerning the unique needs and gifts of its elders. Our mainstream media channels favor the carefree pleasures of youth over the wizened responsibilities of maturation, as evidenced by the promotion of the blank slate of Botox over the telling wrinkles of time and the reinvigorating lift of Viagra over the deepening of more contemplative pursuits. Such insidious biases communicate an all too clear message: that the natural process of aging is to be related to at best as an unavoidable trial to be endured and at worst as a pathology to be mitigated or cured by the scientific powers that be.When we couple our general disparagement of growing old with our stark fear of the related cluster of symptoms known popularly as dementia, literally meaning "loss of mind," it is little wonder that we conveniently tuck in and away our aged and ailing relatives in nursing facilities as a standard practice of care, "homes" that more often than not lack the heart and hearth that have traditionally defined that concept. Indeed, the progressive courses of aging and dementia-labeled experiences are both typically conceived of as regrettable losses that are harbingers of a lonely journey marked by shame and alienation, eventually ending in disorientation and death. Such a passage can represent a terrifying ordeal for the individuals and families intimately acquainted with these experiences of biological decay.The framing of both aging and dementia as mere trajectories of deterioration or illness calls for either treatment or cure as sensible goals. Medical intervention thus logically constitutes the standard practice of care in buffering the inevitable trials of growing old and the diverse symptoms of decay that accompany the aging process. Indeed, the medical model, with its entourage of pharmacological allies, has to date successfully taken the processes of aging and dementia under its hospital wings.Clearly, there is an invaluable place for biologically oriented strategies in ameliorating the unavoidable pain and distress that accompany both aging and dementia-related symptoms, which include impairment in memory, language, decision-making ability, judgment, attention, and physical functioning. Many