Suicide and the Elderly

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What is the problem? Someone age 65 or over completes suicide every 90 minutes — 16 deaths a day. Although elders only account for only 12% of the population, they also account for one fifth of all suicides. The suicide rate among elders is two to three times higher than in younger age groups. The elderly have a high suicide rate due to methods such as firearms, hanging and drowning. Also, double suicides occur most frequently among the aged. Suicide attempts among elderly have less chance of discovery due to greater social isolation and less chance of discovery survival due to greater physical frailty.

What role does depression play? Elder suicide is most widely associated with depression and things that cause depression. Depression remains underdiagnosed and undertreated in the elderly. Studies show that many older adults who die by suicide, up to 75%, visited a physician within a month before death. The risk of depression in the elderly tends to increase with other illnesses. Estimates of major depression in older people living in the community range from less than 1% to about 5%, but rises to 13. 5 percent in elderly who require assistance.

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Some of the things that cause depression are chronic illness, physical impairment, unrelieved pain, financial stress, loss and grief and social isolation. Conwell (2001) reminds us that while these variables are significant, elder suicide has a complex etiology. “General understanding of suicide among older people is often oversimplified, ascribed to a single factor such as severe physical illness or depression. The reality is far more complex. There is no single cause for any suicide, and no two can be understood to result from exactly the same constellation of factors. Depression is also tied to low serotonin levels. Serotonin is a neurotransmitter which limits self-destructive behavior. Serotonin is a transmitter that decreases with aging. This makes it more the elderly more susceptible to committing harmful acts on themselves. Also, risk sometimes accumulates among the elderly. For example, an individual may be physically ailed, an alcohol misuser and may lose a spouse and become chronically depressed. These trumped up complications can lead someone to suicide who has never even considered it before. Is depression just a part of aging?

Depressive disorder is not a normal part of aging. Emotional experiences of sadness, response to loss, grief and the blues are normal. However, depression that interferes with the ability to function normally is not. There is a low rate of diagnosis and treatment in older adults. Health professionals may mistakenly think persistent depression is an acceptable response to other serious illnesses and coping with the way their lives have changed. Although some elderly people may share this attitude as well, it is not necessarily true. Depression should be treated when it occurs at the same time as other medical illnesses.

Untreated depression can delay recovery or worsen the outcome of these other illnesses. Are some ethnic/racial groups at higher risk of suicide? For every 100,000 people age 65 and older in each of the ethnic/racial groups below, the following number died by suicide in 2004: •Non-Hispanic Whites — 15. 8 per 100,000 •Asian and Pacific Islanders — 10. 6 per 100,000 •Hispanics — 7. 9 per 100,000 •Non-Hispanic Blacks — 5. 0 per 100,000 What are some of the myths? •Those who complete suicide do not seek help before their attempt. •Those who kill themselves must be crazy. Asking someone about suicide can lead to suicide. •Pain goes along with aging so nothing can be done. •It makes sense for an old person to want to end their suffering. •Old people are used to death and loss and don’t feel them like younger folks. •Those who talk about suicide rarely actually do it. •If someone’s determined to kill themselves, no one can stop them. Although some of these myths may seem to be a reality, it is imperative that we do not assume any of these to be the case. This is how our elderly population decreases due to suicide and also how we miss the warning signs that something is not right.


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