By 2030, due to the aging of the baby boomers, the U.S. Census Bureau predicts that nearly one in five people will be 65 or older—a substantial increase from the 13% of the population that was 65 or older in 2010. This population of older adults is projected to have increased needs for mental health care, which the current workforce is inadequate to meet (1, 2). For example, by the year 2050, an estimated 13 million adults will suffer from Alzheimer’s disease (AD) (3). Many of these individuals will develop behavioral and psychological symptoms as their disease progresses. Depressive disorders remain underdetected in older adults, and despite years of attention to the issue of undertreatment of depression in the older adult population, this continues to be a problem (1, 4). Ongoing stigma about mental health treatment on the part of patients, as well as misconceptions and inadequate training regarding depression on the part of health care providers, likely contribute to the lack of identification and treatment of depressive disorders in older adults (5). Thus, although many older adults will age “successfully,” with intact cognition and stable mental health, a substantial minority will experience new onset psychiatric disorders, recurrence of disorders that initially developed earlier in life, or psychiatric manifestations of neurologic and medical disorders and their treatment. Special ethical challenges emerge at the intersection of aging, comorbidmedical illnesses, and psychiatric illnesses. Although a complete discussion of these issues is beyond the scope of this column, two topics that have received relatively little attention in the literature—financial exploitation and ethical issues in hospice care for patients with psychiatric disorders—will be discussed through the use of case examples.