‘Patients bring more than just their bodies and diseases’ (Baker et al 1999: 173) The study explores what may be the nature of the need, if any for counselling/psychotherapy for older people who suffer a debilitating physical injury or illness. This is explored within medical settings where the emphasis is on the physical functional rehabilitation of people who have suffered a variety of physical traumas. The theoretical issues related to this are the ageing process and old age, the body, the ‘self’ and, the impact of the trauma. The literature review, whist acknowledging that people do suffer emotional and psychological reactions, offers very little literature on both the practicalities and theoretical orientation of work with people with chronic physical illness or injuries and, in particular, with older people within medical settings. It is documented that depression influences a person’s engagement with rehabilitation and delays discharge, plus increases use of medication. This study shows an awareness of these issues and of counselling/psychotherapy approaches that may be helpful in these circumstances.