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Elder Suicide – A Late Life Tragedy

 

Tony Salvatore

 

Montgomery County, PA residents were shocked by the suicide of an elderly woman on Father’s Day 2006 in Plymouth Township near a softball field where a game was underway.  This sad event was unusual because the victim was a 79-year women and a handgun was used.  Elderly women do not complete suicide as often as their male counterparts and use firearms far less frequently.

 

Media coverage focused mainly on the “public” nature of the death.  This reflects our limited public understanding of elder suicide.  We need to know more about this problem and our concern can’t be limited to losses that occasionally catch us off guard.

 

Try this short True/False quiz to test your knowledge of elder suicide:

 

  • Elder suicides outnumber teen suicides in Montgomery County by over 3 to 1.
  • Most elder suicide victims are white males.
  • The suicide rate of white men age 85 and over is 6 times the national suicide rate.
  • Someone 65 or over completes suicide every 90 minutes.
  • Elders make up 13% of the US population and 20% of all suicides.

 

These statements are all true!  They have been well-known facts for a long time.  Nonetheless few would probably get even one of our quiz questions correct.

 

Why are we so uninformed about suicide among elders?  For a start, we don’t hear about elder suicides as much as those involving younger individuals.  Why?  It may be because society doesn’t see suicide in elders the same way as in other groups.  This may be because the victims are felt to be old and at risk of dying anyway or because suicide may seem “rational” if chronic or terminal illness is present.

 

The burden of loss with the suicide of an older individual is no less than for suicides among the non-elderly.  Losing anyone of any age to suicide is devastating to those directly affected.  Like all suicides, those involving elders send a “message” that suicide is an option if things get bad enough.  For these reasons and others, we must try to prevent elder suicides and act to keep their number from rising as the aged population swells in coming decades.

 

We can start with the key factors linked to elder suicide.  These include depression, a significant personal loss (e.g., the death of a spouse), decreased quality of life and self-sufficiency, fewer social ties and supports, and serious physical and cognitive impairments.  Also involved are misuse of alcohol and prescription and over-the-counter medications as well as a resistance to seeking help and inflexibility about change. 

 

Next we must learn some of the key warning signs:

 

  • Loss of interest in things that are usually found enjoyable
  • Cutting back social interaction, self-care, and grooming.

·         Breaking medical regimens (e.g., not renewing prescriptions)

  • Feeling hopeless and/or worthless ("Who needs somebody like me?").
  • Stockpiling medication, getting a gun or other lethal means.

 

These are all signs that something is wrong.  None are “normal” in the elderly.  If you see them in someone directly ask if he or she is thinking of suicide or self-harm.  If the answer is yes, say that you care and want to help.  If they give a reason for wanting to die, don’t minimize its meaning.  Offer to assist in getting help.  Don’t hesitate to call 9-1-1 if the individual voices clear intent, talks about a suicide plan, or has access to lethal means.

 

Here are some practical steps to take to prevent elder suicide:

 

  • Get the word out to elders and their families that late life depression is readily treatable condition that may lead to suicide if not addressed.
  • Facilitate routine screenings for depression and suicidality in primary and specialty medical services used by the elderly.
  • Mobilize medical office staff, home care workers, pharmacists, and others with daily contact with elders as “gatekeepers” to identify those at-risk and refer them for help.
  • Expand elder-oriented mental health services and integrate mental health interventions into health services used by the elderly.
  • Train police, EMTs, and ER workers to recognize possible suicide attempts that may be mistaken for accidents.
  • Encourage disposal of unused firearms in the home and promote safe storage of all firearms

 

Above all, it must be accepted that elder suicides, like those of adults and youths, are preventable and premature deaths that do not have to happen.  We can keep elder suicides from occurring by making elder suicide prevention an objective of the health care, aging, and mental health service systems and getting them to work together to achieve it. 

 

6/06