In our society, changes in older adulthood are consistently framed in terms of loss and deficiencies. This paper examines the prevalence and nature of depression among the elderly, and how depression relates to the developmental stage of older adulthood. Mental health concerns, particularly depression, are widespread among older adults. Focusing on the Native American elderly, a disproportionately impoverished minority population with a disproportionately high rate of older adult depression, this paper uses a multicultural lens to examine the different experiences of depression among older adults, and the resulting implications for service delivery. Increasing knowledge in the professional community has important implications for increased coordination and improved services for older adults suffering from depression.