Talking About Suicide With Senior Loved Ones
September Is Suicide Prevention Awareness Month.
Sponsored by the National Alliance on Mental Illness, this annual event seeks to shed light on a topic that most people would rather not talk about—but should, because silence and stigma mean that many people are unable or unwilling to get help until it's too late.
News coverage often focuses on suicide among younger people, perhaps highlighting the most recent tragic death of a talented performer or perhaps a student unable to cope with bullying. Yet few people realize that the suicide death rate is highest among seniors. According to the Centers for Disease Control and Prevention (CDC), 7,125 people older than 65 died by suicide during 2013. The suicide rate among older men is higher than any other group in the U.S. The CDC says that while older women experience more suicidal thoughts and attempts, more suicide attempts by older men are fatal, because they are more likely to use a firearm than intentional drug overdose or other means.
In addition, reports the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), suicide attempts by older adults are more often fatal because many live alone, making it less likely that someone will be able to save them in time. Physical frailty makes seniors less able to recover from an attempt. Older adults also are far less likely to report it when they have serious thoughts of suicide. SAMHSA has been providing training resources for senior service organizations to help them get this important topic out in the open.
If you are an older adult, or have older loved ones, or are a senior care professional, it's important to know about the risk factors, warning signs and prevention strategies for suicide. SAMHSA says that several risk factors put older adults at higher risk of suicide:
- Mental illness and mood disorders, especially major depression.
- Substance abuse and misuse, which includes alcohol, prescription and over-the-counter medications, and other controlled substances.
- Physical illness that causes pain, disability or insomnia.
- Stressful life circumstances, such as giving up driving, loss of a spouse, mobility limitation and social isolation.
- Feelings of hopelessness—a lack of purpose, low self-esteem, or a feeling of "being a burden."
- A history of suicide attempts or a family member who has ended their life.
- Access to means of suicide, such as firearms or large amount of certain medications.
Don't ignore the warning signs.
Beyond the above risk factors, say experts, the following warning signs could mean an elder could be in immediate danger:
- Making statements such as "Life's not worth living" or "Everyone would be better off without me."
- Giving away belongings; a new preoccupation with "getting their affairs in order."
- Buying a firearm or stockpiling pills when they have not done so before.
- Saying goodbye to family and friends.
If you believe the person is in crisis, contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) to talk to a skilled, trained counselor at a crisis center in your area, day or night.
Lowering the risk
If a senior loved one often seems to be depressed or in despair, the first step is to talk about ways they can feel better and how you can help. Geriatric psychologists recommend five steps to reduce the risk of suicide in older patients:
Seek treatment for depression and other mental illness. Depression is very common in older adults, so much so that some people think it is normal. But it is not. If your loved one is exhibiting signs of sadness, helplessness, lack of energy or lack of interest in activities that used to bring pleasure, they should be evaluated by a doctor. Depression is treatable. Medications, counseling and lifestyle changes can make a big difference.
Manage health conditions. As we grow older, we're more likely to suffer from physical and cognitive ailments that challenge our ability to feel good about life. Regular healthcare appointments, following the doctor's recommendations and living a healthier lifestyle can help seniors feel better and more empowered. Medication management also is important, both to ensure your loved one's medications are doing what they're supposed to do, and to avoid negative side effects.
Seek out social connections. Loneliness is one of the most pernicious conditions humans can experience, yet old age presents challenges even for lifelong social butterflies. We retire from our jobs, children leave home, or we might lose our spouse or move away from our long-time neighborhood. If your loved one isn't spending much time with others, check out some of the social opportunities for older adults in your area, such as senior centers, your loved one's faith community, parks department programs, or even Facebook. If your family uses professional home care services, remember that providing companionship at home is only the beginning; the caregiver also can transport your loved one to other social events.
Promote a sense of purpose. The life changes mentioned above can rob us of our self-esteem and the sense that we make a difference in the world. Help your loved one discover new ways to find meaning in life by learning a new skill, taking up a hobby, or following spiritual pursuits. And millions of seniors can vouch that volunteering is the very best way to make a difference. There are volunteer opportunities for people of every ability.
Recognize and treat alcohol and drug abuse. A senior can slowly slide into a pattern of drinking more and more, using illicit drugs, or taking more pain medication than the doctor recommends. Today the rate of opiate addiction is growing fastest in the senior population. Substance abuse and misuse lead to falls, poor-quality sleep and overall decline. Your loved one should discuss all medications, prescription and otherwise, with their doctor.
Suicide Prevention Awareness Month is sponsored by the National Alliance on Mental Illness. Visit their website to find resources for suicide prevention, how to help a loved one who has expressed suicidal thoughts, and help for suicide survivors and their families.
The National Institute of Mental Health is another good source of information on suicide prevention.
The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor about depression and suicidal thoughts. If you think a loved one is at high risk of suicide or you are having suicidal thoughts, don't delay. Contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or online.