Physiotherapists are regularly called upon to administer intervention, provide consultation and guidance, as well as long-term care and follow-up to the elderly. For a physiotherapist, the main goal of such intervention is to optimize function, improve quality of life, and improve social participation. In addition to disease and social problems, psychological factors also play a vital role in defining the health status of the individual and predicting recovery. Rehabilitation and holistic care for the elderly, hence, is multifactorial. Numerous psychosocial factors can affect the individual, which, in turn, affect the direction of physiotherapy intervention and patient outcomes, in both positive and negative ways. Hence, a physiotherapist should be able to understand and consider the same while providing intervention for better functional gain and social contribution. This chapter delves into what physiotherapists should know to assess the psychosocial factors affecting the individual, how they should consider the same while performing the necessary therapeutic intervention, as well as determining types of treatment that will optimize functional skills and participation goals in the elderly and understand indications for referral to a counselor or a psychiatrist.