Don’t think it can’t happen.

Elder suicide rates are up in the United States and it usually start with depression–also a major factor in the elderly.

It’s a deadly combination–life debilitating illness, loss of spouse, career, a terminal diagnosis, medications all exasperate the situation.

But it’s not the way we want it to end.

It’s not the family legacy most of us aspire to.

Depression affects approximately 19 million Americans per year, (National Institutes of Mental Health, 2000).

Depression is often not recognized in the elderly because the symptoms can be attributed to ”normal aging.” How sad, that we have come to believe that melancholy, lethargy and apathy are connected to older age.

Nearly 6% of the people in the United States over the age of 65 have a diagnosable form of depression, and while adults age 65 make up?only 13 percent of the U.S. population, they account for 20 percent of all suicide deaths.

We should be more alarmed.?

Who is most at risk? Our dads. Our husbands. Our brothers.

Male Caucasians who are over the age of 85 are the the highest suicide rate in the nation (National Institute of Mental Health, 2000). But don’t think mom is out of danger. While men tend to be more violent in their attempts, women tend to lead toward pills.

They’re also not talking. Elders are not like teenagers who threaten, make dramatic attempts in order to stopped (subconsciously). Many elders are not comfortable talking about mental illness and so they suffer intense feelings of loss, hopelessness and despair alone–never realizing there is help. They don’t have to feel this way.

Factors that Lead to Suicide:

• Recent loss of a spouse, loved one, or pet
• Debilitating or life-threatening illness
• Pain, especially if pain is severe, chronic, and/or inescapable
• Loss of independence and/or mobility
• Inability to live alone
• Loss of employment or productive activities
• Financial difficulties
• Depression
• Alcohol abuse and/or dependence
• Loss of role or stature in family and community
• Feelings of hopelessness and helplessness
• Physical, social, and emotional isolation

What are the Warning Signs:

• Statements about death and suicide
• Reading material about death and suicide
• Statements of hopelessness or helplessness (e.g., “I don’t know if I can go on.”)
• Disruption of sleep patterns
• Increased alcohol or prescription drug use
• Failure to take care of self or follow medical orders
• Stockpiling medications
• Sudden interest in firearms
• Social withdrawal or elaborate good-byes
• Rush to complete or revise a will
• Overt suicide threats

How to Help:

• Be aware of your elder’s emotional state
• Be sensitive?in times of a new loss, such as?the loss of a beloved pet or dear friend
• Consider filtering the news–more negativity about the state of the world, wars, and the economy might not be the best thing for any of us to focus on
• Make a list of who your elder or spouse is most likely to talk to–a priest or pastor, a close friend, a nurse or doctor they’re closest to–let this person know of your concerns and ask them to listen closely for tell-tale signs.
• If you’re truly concerned, then talk openly about your concerns of depression and the risk of suicide. Don’t think you’ll cause suicide by talking about it.
• Let them know that their thoughts and feelings are normal, that despair is common, and that there are people who care who can help, that part of their feelings are triggered by life events, but also diseases and medication play into this.
• Let them know you’re not judging them. Life is hard. But this is not an option. You are there to help. There are medications, people to talk to, that their thoughts and feelings can change. Life is full of changes and this situation doesn’t have to stay the same.

I’m Afraid to Broach the Subject:

• They will get angry with me or deny it. So what if they do? This is too important and the risk is worth it. You don’t want all your love, time and caregiving to end this way. You don’t want this blow to hit you and your loved ones.
• I might put the suicidal thoughts into their heads. If your loved one is having suicidal thoughts, then they’ve probably been having them for weeks, months, or even years. For many people, depression is a lifelong battle and this may not be the first time they’ve found themselves in this debilitating emotional state. It is extremely unlikely that a caring question from another would convince a person, whether truly depressed or not, to commit suicide.

• I won’t know what to say. I know, this is tough. Bungle your way through it. Don’t think you’ll handle this perfect. You have no experience (I hope). Your love and emotions will come through no matter what words you are able to get out. It’s not your words that will convince them to get help–it’s your love and concern.

• Suicide greatly affects your life and other family members. Suicide ripples into the fabric of humanity. It’s a devastating blow for those nearby, so do all you can to prevent this tragedy.

• End of life and palliative care (to reduce pain during the last weeks and days of dying) is a different subject. This is a highly controversial area and one that should be handled privately with your “council of elders” (family, chaplainor other faith leader, hospice, etc.).

How to Help Someone Who is Deeply Depressed and May Be Suicidal:

• Be sensitive, honest and straightforward. Come right out and ask: “Dad, I’ve been worried about you lately. You seem pretty down. I’ve noticed that you aren’t seeing your friends any more, and you’ve talked about not wanting to go on. Would you really want to die?”)
• Listen. After you’ve opened the discussion, then let them talk. Listen–listen all day long, ask questions that will encourage them to continue to talk and open up. Caregiving is more about listening than it is a to-do list.
• Seek help yourself–dealing with someone who is suicidal kicks up all kinds of emotions, particularly if they’re your spouse or parent or other close family member. Talk to your pastor or doctor or call a suicide hotlineand let them know what you’re dealing with. Alzheimer’s Association and other organizations also have great hotlines withpeople who care, who know what it’s like to deal with depression and stress on top of a horrific disease. Reach out.

What If I Find Out They Are Contemplating Suicide:

• Do your homework. Make sure you know about the resources available in your area:
• Check the front of your telephone directory–or the Internet, as well as your local community mental health unit. They often have suicide hotlines and emergency inpatient crisis stabilization units available if the danger of suicide is high.
• Let your elder/spouse’s doctor know. Certain diseases and medications can aggravate the situation.
• A psychologist, psychiatrist or other therapist is another good option but check with your insurance as to what is covered.

Practical Things You Can Do:

• Get the guns out of the house
• Monitor all medications, including your own
• Stay close by. If you’re in a particularly dangerous time, monitor them 24/7 by granny cam/baby monitors
• Take threats serious and cause a fuss–make it unappealing to try again
• Get help immediately if there is an attempt. Don’t worry about embarrassment–this is bigger than that.

YOU need to deal with this in your own life and heart. YOU can’t control what someone else does, so stay with you. Love you. Care for you.

Your goal is to prevent a tragedy. Be aware. Be sensitive. Speakup–this is worth fighting for.

Resources:

www.metanoia.org/suicide/

www.suicidepreventionlifeline.org/

www.save.org/

suicidehotlines.com/

~Carol D. O’Dell

Author of Mothering Mother: A Daughter’s Humorous and Heartbreaking Memoir

available on Amazon

www.mothering-mother.com