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Tue 3 Jun, 2003 09:48 am
Elder suicide: Are you aware of it?
By Ezra Ochshorn
TAMPA, FLA. – If you ever want to bring a discussion of serious health issues to a screeching halt, simply utter two words: elder suicide. I repeatedly experienced this when talking with fellow students and mental-health professionals during my years in graduate school and while working as a counselor on hospital psychiatric units. Although suicide-prevention programs have proliferated in recent years, almost all attention has been directed at teenagers. This national focus ignores a basic fact: Seniors have the highest suicide rate of all age groups. While people aged 65 and older comprise only 13 percent of the US population, they account for 19 percent of all suicides. The suicide rate in 1999 among 15- to 24-year-olds was 10.3 per 100,000, while among the aged it was 15.9 per 100,000 (almost 50 percent above the national average). This statistic translates into a total 6,000 elder suicides, and most experts believe the actual, unofficial number is considerably higher.
Why has this issue received so little publicity? I believe the answer lies in our youth-obsessed society's fear of aging. This contributes to ageism - a belief that the elderly are inferior, and people to be kept out of sight and mind.
As a result, the struggles of older people are given short shrift in American life.
There is also widespread belief that depression - considered the greatest risk factor for suicide - is a natural part of aging for which there is no remedy.
Certainly there are life circumstances that can hit the elderly especially hard, such as physical illness, loss of family and friends, and the need for care. But depression is not linked to aging itself, and most seriously depressed seniors respond well when their problem is acknowledged and treated.
Yet proper treatment occurs all too rarely. Most general physicians have little if any training in evaluating suicidal risk among the elderly.
This is significant because research indicates more than 70 percent of seniors who kill themselves see a physician within the preceding month, and most give verbal or behavioral clues as to their deadly intentions.
Physicians are not alone in this regard. For example, the vast majority of social workers, who provide half of all mental-health services in this country, have no specific geriatric training. It is predicted there will be an acute shortage of specially trained doctors, social workers, and other health professionals over the coming decades as the elderly grow to represent an unprecedented proportion of the US population.
Although many Americans view suicide as a taboo subject - particularly when not concerning teenagers - it will not magically disappear if ignored.
The number of older Americans is expected to double by 2030 - and unless the issue receives serious attention, suicides can reasonably be expected to increase accordingly. Here are some suggestions for change:
• Increase public-health efforts to raise awareness of elder suicide. This should include discussion of social, economic, health, and psychological risk factors that lead to suicide.
• Increase the number of health and mental-health professionals trained to work with seniors. This may require providing incentives such as scholarships and loan-forgiveness programs for those who choose a geriatric concentration.
• Combat the stigma many seniors associate with receiving mental-health treatment.
• Develop and fund community treatment programs for the elderly. Everyone should be entitled to accessible and affordable mental-health services.
• Most important, the ageism that permeates American culture must end. It is only when everyone is regarded and treated as unique and valuable that suicides will decrease. Regardless of age, people with purposeful lives, good self- esteem, and a supportive environment rarely choose to kill themselves.
A sad commentary don't you think. That is what happens when the "Golden Years" turn to rust.
I would be interested in finding out why they committed suicide. It seems to be very different if it was because of depression in and of itself (analagous to teenagers) vs. because they have an incurable disease/ quality of life issues.
Ask me questions if you like. My father committed suicide when his health became very fragile. He was 68, but a very old 68. It happened in 1990, and I found a good support group that helped me understand it very well. I am open to questions.
I too have some personal experience.
Part of what I am getting at that was probably not clear is that the tone of the article is generally sad and disapproving -- all of these old people are killing themselves, we have to stop them. If they are killing themselves because of issues with depression that can be solved, I agree completely. If it is more of a euthanasia situation, that is more complicated.
We agree, soz. One helpful note...some of the problems with depression in the elderly are generational. My father's generation did not believe in counseling or therapy. And did not trust psychological drugs. The generations since his have become more accepting of help.
Gotta run. Will check back in on this thread later today...
sozobe
In my opinion the finger can be pointed at quality of life. I can say that from my own feelings and experience. Suffice it to say that after 10 years of health problems, pain and restricted living there are days that I say to myself who needs this The pain and health problems I can live with it's the restricted living {quality of life] that bothers me the most. Of course I would never resort to suicide for both religious reasons and the pain and emotional trauma of the loved ones left behind.
It could be one reason or many. Unless we understand the whole individual, it will be difficult to arrive at simple conclusions. Health, money, loneliness, depression, can all play a part. c.i.
c.i.
Aside from possibly a terminal illness the problems you mentioned are all quality of life issues.
One of my psychology professors really was up-to-date to thais theme: it has been discussed at university since 1985.
In 2000 (this are the last figures I got, since he retired recently), out of the 13,000 suicides in Germany every third was commited by seniors of 65+. (This number grew in 15 years at 13,5%)
Reasons for this are here:
- the complexity of reality, under which many seniors suffer,
- the fact that about half of the seniors live alone,
and
- the fast growing expectancy of life.
In many cases suicide is an effort to repudiate a powerless life by taking control and acting to end that life.
There are also passive suicides: the lonely old people who refuse to turn on fans or air conditioners in the middle of heat waves; the old people who "forget" to take their pills (their health isn't important enough to them to make an effort ot remember; the weary old people who are "too tired' to cook.
Discourage suicide--but what reasons are being offered to the elderly to stay alive? Should "society" or "government" carry the responsibility of making life meaningful for the elderly?
Noddy24
Your question should be do the young have a responsibility for the old. Oddly enough in most primitive societies there is no question that they do. However, in our civilized, high powered, enlightened society we have to ask the question. How ironic.
au1929--
"The Young"...."The Old"....we're getting into insubstantial ground here.
If someone offered me $1,000,000 in exchange for approving the death of a citizen of China whom I would never know, I would turn down the money.
If you want to hold me responsible for the death of an elderly woman in Chicago who will not turn on her fan during a heat wave, I'll mutter, "No man is an island...." and then ask you what you are going to do because my plate is full right now with local problems--believe me, I have local problems.
Further, my son and daughter-in-law are not responsible for providing me with a Reason To Live or a Will to Live or the common sense to come in out of the rain.
If, as the Quakers phrase goes, you are "called" to succor the elderly, more power to you. If you feel "called" to admonish "the young" for neglect find some "young" and do some hands on missionary work.
Good luck!
Noddy24
Quote:Should "society" or "government" carry the responsibility of making life meaningful for the elderly?
I was only attempting to answer your question. You asked about society and government I related youth to society. The answer is yes as much as possible. We should not be a throw away society.
au, That "we should not be a throwaway society" is kind of moot, isn't it? c.i.
c.i
When I spoke of a throw away society I was referring to the aged in our society.
au1929--
I hope my reply didn't sound like a personal attack. Care of the Elderly--like other social problems--needs someone who is going to Bell the Cat. Assigning "youth" to the problem instead of "society" or "government" does not solve the problem.
If depression is the problem, (too tired to cook, too tired to turn on the fan, etc.) medication can usually restore a balanced outlook.
No matter what age a person is, there are still things to enjoy. My husband's 101-year old grandmother could finally no longer walk, write or even see well enough to read. But she looked forward to seeing her great-grandchildren, talking to them on the phone, eating her chocolates, visiting with her daughter, and talking with the home health care nurse who came every day. She was never depressed.
On the other hand, my father could walk, write, read and do many things, but because of depression, he lost the ability to enjoy anything. He refused to take pain medicine in the belief that it indicated weakness of character. He never admitted his depression, although it was obvious to everyone. He would certainly never have discussed it with a physician or therapist. In the end, he chose to "take himself out" rather than become dependent on others for daily care.
It is sad, but when someone denies a problem and refuses help, there is very little that anyone can do.
Happily, younger generations now have a better understanding of depression, its hereditary nature, and are more willing to try medications and counseling. In addition, much progress has been made in antidepressant medication itself.
In cases of terminal illness, when pain becomes unmanageable and there is no quality of life left, I believe suicide should be an accepted alternative. Hell, we do that much for our pets!
au, I know what you meant. "Throw away" is a bad term for whatever shortcoming humans have in not caring for our aged. In many developed societies, and especially in Japan, where three and four generations used to live under one roof, that phenomenon is now changing. Young families are moving out on their own into single family homes. Even in the US, we rarely see parents living in the same house as their children. Another interesting dynamics is seeing grandparents caring more and more for their grandchildren, while the parents both work full time jobs. I'll leave it to the social scientists to figure out why this has happened. We have my wife's mother and our young son living in our home. It creates a little inconvenience, but I could live with it. I'm not sure I'm ready to take care of grandchildren on a full time basis, and commend those that are doing it. c.i.
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