This century has seen the forced movement of millions of people all round the world and the anguish and emotional cost of such migrations is only now receiving attention: In 1990 the literature contained a few references on the mental health effects of war but eight years on there are more papers published which describe supportive programmes available to displaced people. Older people in any society form a significant percentage of the population and when an older person is forced to leave home it is with the possibility that he or she will never see it again and to function in new surroundings takes energy and resourcefulness. An older person is vulnerable. This article describes programmes which have older refugees as the focus. It describes the problems of creating such programmmes and the importance of listening and making contact with the individual in order to build up a trusting relationship. This contact goes some way towards understanding the culture, social customs and the political realities. The difficulties of working across cultures and languages are discussed. The role of the helper, whether an international aid worker, or a local professional using his or her skills in a refugee camp, is examined when the idea is posed that organisations offering help to refugees need also to offer effective support to helpers who can be affected by the traumatic events that have occurred and which affect individual refugees. Programmes offering therapy and counselling to refugees of all ages are relatively new. That individuals in these stressful situations seek medical help for physical ailments for which there is no apparent physiological base is an indication of the psychological stress experienced. The challenge is the recognition of the importance of psychosocial programmes by international bodies who provide resources for refugee aid.

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