When Hope Dies: How to Recognize Suicide Risk in Older Adults

It’s a sobering fact: According to the U.S. Centers for Disease Control (CDC), more Americans die from suicide than homicide. Even more sobering: Older Americans are much more likely to take their lives by suicide than teens or young adults, the two age groups that receive the most attention for being at risk.

In a 2012 study using 2009 data, the CDC found that the national suicide rate, when adjusted for age, is 11.8 deaths per 100,000 population—about twice as high as the national homicide rate (5.5). At greatest risk are adults 45 and older, with suicide rates in the high teens.

The U.S. Administration on Aging reports that older, white males are at the highest risk, with 30.3 suicides per 100,000.

It is difficult to imagine that your aging loved one may be contemplating suicide. But the aging process can lead to isolation, painful disease or physical ailments, loss of a beloved partner and friends, loss of a home and independence—all stressful changes that can bring on depression and a sense of hopelessness that may prompt a person to want to end it all.

Of course, not every older adult who feels sad or depressed is considering suicide. Those feelings can certainly be part of the normal process of grieving when a loved one dies or the individual experiences other significant losses.

But it’s important to recognize warning signs of an older adult who is at risk of taking his or her own life.

Social Isolation and Depression Increase Suicide Risk in Older Adults

According to the Samaritans of Merrimack Valley, older adults are not only at greater risk of attempting suicide, but also more likely to succeed, due to social isolation and a resistance to talking about depression:

  • Fewer warning signs or explicit cues—Older adults may not be very communicative about how they are feeling or what they are considering. Depression is common with painful illness and aging, although older adults often have less contact with mental health professionals.
  • Higher likelihood that a suicide attempt will succeed—The elderly are more likely to die from suicide attempts than younger people because they are frailer. They may be quite focused on planning, be secretive, avoid interventions and take precautions against anyone finding out what they have in mind.
  • Lower likelihood of discovery—Social isolation can leave older adults to their own devices, without emotional support or reality checks to help them see alternatives to suicide.
  • Stigma associated with mental health issues—Older adults may feel ashamed to contact a mental health professional, acknowledge depression or seek help for emotional issues and concerns.
  • Past history not necessarily predictive—An older individual may not have a history of past suicide attempts—one of the main predictors of suicide—but still turn to suicide when depression and hopelessness become overwhelming.

Other risk factors for suicide, for people of all ages, include:

  • Being male. Although women attempt suicide three times more often than men, four times more men than women die by suicide. Risk of suicide declines among women as they age, but increases for men.
  • Family history of suicide or mental health challenges
  • History of physical, alcohol, drug or other forms of abuse
  • Loss of significant other, family member or other close relationship
  • Major life changes, such as divorce, retirement, moving, financial problems
  • Previous suicide attempts
  • Lack of support systems, poor help-seeking skills
  • Access to means of taking one’s own life

How to Recognize Suicidal Warning Signs in Older Adults

There is no obvious profile for an older adult who is contemplating suicide. Probably the most important warning sign is a significant change in behavior. If your loved one was once social and outgoing, but has become withdrawn and reluctant to communicate, you may have cause for concern. Here are some more warning signs:

  • Depression in older adults can manifest in a variety of ways. Has your loved one become withdrawn or, possibly, angry, irritable or hostile?
  • Does she express feelings of hopelessness, that she no longer has a reason for living?
  • Is he angry to the point of raging or seeking revenge?
  • Does she seem reckless or impulsive, engaging in risky activities without thinking?
  • Does he express a feeling of being trapped, having no way out of his current circumstances?
  • Has she lost interest in hobbies or other favorite activities?
  • Has he suddenly updated his will or given away prized possessions?
  • Has she lost interest in keeping up her appearance?
  • Does he refuse to connect with others who might be of help?
  • Do you see any increase in drug or alcohol use?

What You Can Do to Help

Keeping the lines of communication open with your aging loved one is the best way to address issues before he or she becomes so desperate as to seriously consider or attempt suicide. The more your loved one can maintain good health habits—including proper sleep, nutrition, exercise and interaction with supportive family, friends and other valued social connections—the better his or her chances of managing the inevitable sense of loss and sadness that can accompany the aging process.

If you suspect that your loved one is sliding into depression and you observe any of the warning signs listed above, don’t be afraid to ask if he or she is contemplating suicide. Bringing up the topic for an honest discussion does not increase the risk of suicide; in fact, in can be a relief for your loved one to have you notice that she or he is in emotional pain.

However, you should seek immediate help from a mental health professional—or, in case of extreme risk, call 9-1-1—if you observe any of the following:

  • Your loved one threatens to hurt or kill himself, or talks about wanting to hurt or kill himself.
  • Your loved one seeks ways to kill herself by seeking access to pills, firearms or other means.
  • Your loved one talks or writes about suicide, death and dying.

For more information about suicide prevention and older adults, see Older Americans Behavioral Health Issue Brief 4: Preventing Suicide in Older Adults, a publication of the U.S. Substance Abuse and Mental Health Services Administration and the Administration on Aging.

President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.

For more on coping with aging, follow us on Twitter: @DeborahFinsGCM.

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