The Elderly and Suicide Debbie Merkel, BA Lincoln Health Care Center Mobile Crisis Specialist The Elderly and Suicide- Facts Elderly- people over the age of 65 13% of the population Account for 1/5 of all suicides Individuals born between 1946-1965 are expected to commit suicide more than any other generation 30,000 suicides annually The Elderly and Suicide- Facts Every 97 minutes a person age 65 and over dies from suicide Tend to be violent deaths Senior suicide rates are most effective; 1 in every 4 attempts as compared to youth rate of 1 in every 150-200 attempts Alcohol plays a diminished role in later life suicide The Elderly and Suicide- Facts White males over 80 are six times more likely than the national average to commit suicide than other groups; twice that of the general population 15 elderly suicides occur each day, resulting in 5,421 suicides in among those 65 and older each year. The rate of suicide for women typically declines after age 60 (after peaking in middle adulthood ages 45-49) The Elderly and Suicide- Facts The elderly are the LEAST likely to reach out to a crisis hotline than any other age group Elder suicide may be under reported by 40% or more (silent suicides)- deaths for medical non-compliance- overdoses, self-starvation or dehydration which occur in nursing homes, or deemed accidents The Elderly and Suicide- Facts Fastest growing segment of the US population is 85 or older; 2% of the total population In 1990 there were 4 million people age 85 +; in 2040 there will be 40 million The Elderly and Suicide- Depression Depression: serious medical condition that negatively affects how one FEELS, ACTS, and THINKS. It does not discriminate. It affects people of all ages. Depression IS NOT a normal sign of aging Depression occurs in about 15% of those 65+ (6 million seniors) no different than the general population as far clinical depression occurs Only 10% of elderly sufferers actually seek out medical help The Elderly and Suicide- Depression *80% of elders who go into a clinic, go in with physical issues which are psychiatrically driven Tends to last longer in elderly adults It doubles their risk of cardiac diseases and increases their risk of death from other illnesses It reduces an elderly person’s ability to rehabilitate The Elderly and SuicideFactors that Increase Depression Being female Being single, unmarried, divorced, or widowed’ Lack of a supportive social network Stressful life events Lack of spirituality The Elderly and SuicideFactors that Increase Depression Family history of major depressive disorder Living alone / social isolation Past suicide attempts Presence of severe or chronic pain Previous history of depression Recent bereavement Substance abuse Insomnia The Elderly and Suicide- Depression Physical conditions and use of medications may actually lead to symptoms of depression. Diseases Thyroid Disorders Diabetes Parkinson’s Disease Multiple Sclerosis Strokes, Cancers Tumors Arthritis Visual Impairments Medications Blood pressure meds Arthritis meds Hormones Steroids The Elderly and Suicide- Risk Factors Differ for suicide among older person than among the young Social Isolation- no social network; friends passing away; loneliness; loss of driver’s license Physical Illness- or fear of prolonged illness; perceived poor health Highest among divorced or widowed Economic Pressures- living on fixed incomes The Elderly and Suicide- Risk Factors Single, male, advancing in age Significant life events- loss of a loved one; a move from their home to a facility; loss of independence / mobility; loss of health- don’t want to be a “burden” on family; retirement Medications Severe and Chronic pain Alcohol abuse and/ or dependence Access to Firearms The Elderly and Suicide- Warning Signs Statements of hopelessness or helpless/ or about death- “I don’t know if I can go on”. “You’d be better off without me. I’m such a burden”. Failure to take care of self or follow medical orders Stockpiling medications Sudden interest in firearms Social withdrawal The Elderly and Suicide- Warning Signs Elaborate goodbyes Giving away personal items Rush to complete or revise a will Suddenly happy / peaceful after a period of gloominess or depression Overt suicide threats The Elderly and Suicide- What to Look For Look for a change in usual activity-Is there a change in function / activities? Not enjoying activities once enjoyed? Changes in sleep pattern? Insomnia? Oversleeping? Changes in appetite that result in weight losses or gains not related to dieting. The Elderly and Suicide- What to Look For Loss of energy / increased fatigue Restlessness or irritability Frequent headaches, stomach aches, chronic pain, somatic complaints Changes in personal hygiene/ housekeeping Not eating properly The Elderly and Suicide- How to Help Be aware of warning signs/ risk factors Don’t be afraid to ask THE QUESTION/ QPR Ask if they have a Plan Keep them talking Encourage them to get help/ Offer to make the call with them Immediate danger, call 911 The Elderly and Suicide- How to Help Encourage Senior to get involved with the local Senior Center Volunteer Contact the Aging Disabilities Resource Center ADRC Grief Support Groups Attend Church groups / Affiliations The Elderly and Suicide- How to Help Encourage Seniors to get check out / hook then up with Interfaith Volunteers Help them obtain Meals on Wheels/ encourage them to go to MOW sites Ask them about their faith- Parish visitors, pastors, church volunteers, interests Get them tied into school or community groups that do outreach The Elderly and Suicide- How to Help Encourage Seniors to eat a Healthy Diet There is HOPE! Help seniors find a purpose in life The Elderly and Suicide- How to Help Medical needs- help them talk to their nurse or doctor (improve communication) may involve ROI Assist seniors in obtaining transportation for appointments (or shopping) The Elderly and Suicide - Treatment Psychotherapy- Behavioral Cognition Therapy Medications- Antidepressants Combination Support Groups- Grief/ Bereavement The Elderly and Suicide References: Office of the Surgeon General Center for Disease Control and Prevention American Association of Suicidology National Institute of Mental Health Department of Mental Health