(9-18-24) September is recognized as Suicide Prevention Month, emphasizing the need to address every instance of death by suicide as a public health issue with far-reaching consequences. Alarmingly, the rates of suicide across all age groups are increasing, particularly among seniors, warranting heightened concern. Factors such as serious illness, chronic pain, mental health disorders like depression, feelings of hopelessness, and social isolation significantly elevate the risk of suicide within this demographic.
"We must continue raising awareness, providing support, and offering resources to individuals and their families impacted by suicide," stated professional fiduciary and certified elder law Attorney RJ Connelly III. "As more baby boomers enter old age, the number of those who commit suicide is growing at an alarming rate, making it vital to address and prioritize the problem not only during this month but every day of the year."
The Centers for Disease Control and Prevention (CDC) has reported that the suicide rate in the United States reached an all-time high in 2022. Shockingly, almost every age group has seen an increase, with older Americans being the hardest hit. The data shows an 8.1% rise in suicide deaths among individuals aged sixty-five and over compared to the previous year. Despite representing only 16.8% of the population, older adults account for approximately 22% of suicides.
Disturbingly, one in four older adults who attempt suicide will succeed, a significantly higher rate compared to youths, where only 1 in 200 attempts lead to success. Even if an older adult survives a suicide attempt, they are less likely to recover due to frailty and underlying health conditions.
"Older adults face an increased risk of suicide due to various factors such as a history of previous suicide attempts, substance abuse, physical illness, loss of independence, loneliness, chronic pain, and depression," said Attorney Connelly. "Let's look closer at some of these factors."
Mental Health
Government studies have revealed that between 71-95% of individuals who died by suicide were dealing with a severe psychological condition at the time of their death. Research on elderly suicide has consistently demonstrated that suicide is notably associated with underlying psychopathological issues. Of these conditions, major depressive disorder stands out as a frequent and significant factor contributing to the heightened risk of suicide. Additionally, there is a strong correlation between feelings of hopelessness and an increased risk of suicide, with hopelessness serving as an established mediator between depression and suicide.
Attorney Connelly often encounters inquiries regarding the precise nature of hopelessness from families who have lost a loved one to suicide. "Hopelessness, particularly prevalent among the elderly, presents an overwhelming emotional barrier that impedes the pursuit of contentment," he explains. "It gives rise to depression, self-criticism, and an overwhelming sense of defeat, depriving seniors of the ability to experience happiness. This emotional state saps their motivation and vitality, leaving them perpetually fatigued and disengaged from their daily lives, devoid of any expectation of positive outcomes in the future."
Physical Health
The prevalence of physical conditions and impairment is alarmingly widespread within the older age group, making it difficult to identify those who require psychological support accurately. There is a compelling correlation between physical health issues and suicide, as the majority of older individuals who die by suicide have underlying health conditions. Suicidal behavior in this population is strongly associated with chronic illnesses and persistent pain.
Retirement
Leaving a job that was once a source of fulfillment and productivity can be a significant mental and emotional challenge for many individuals. Studies from Canada have shown that the initial month post-retirement is crucial for educating people about adjusting to their new lifestyle. In a similar vein, research from Australia has indicated that specific support services aimed at assisting new retirees in transitioning from employment to retirement could potentially reduce the risk of suicidal thoughts and behaviors.
Loss
The loss of a close family member or relative can be an extremely challenging and distressing experience. It can evoke a range of emotions, such as anger, guilt, and despair, particularly when the grieving process takes place in a socially isolated environment, such as a senior who chooses to age in place alone. Research has shown that the burden of grief can lead to a heightened risk of negative health outcomes, including an increased likelihood of suicide. Factors such as a lack of social connections, feelings of not fitting in, and insufficient social support can amplify the trauma associated with losing a close relative and contribute to an elevated risk of self-harm or suicide. One study conducted by Mogensen et al. found that the risk of suicide was most pronounced approximately six months after the passing of a family member or close relative.
Family Problems
Familial issues encompass the instability within a family stemming from sudden changes and unrelated events, leading to disrupted family dynamics and individuals failing to fulfill their family's expectations. A Government study revealed that approximately 35.0% of suicide cases among older adults were attributed to family issues. Within this demographic, the study noted that 18.33% had encountered familial abuse, while 16.67% lived in impoverished conditions.
Financial issues
Financial stress can be a significant risk factor for suicidal ideation, especially for elderly individuals who rely on fixed incomes and struggle to cover their day-to-day expenses, including bills and groceries. This situation can be further complicated by existing health issues or the experience of grief, making it even harder to cope with these financial challenges. Recognizing these potential risk factors and providing support for those dealing with financial stress and its impact on mental health is crucial. Research has shown that financial difficulties were a prominent source of stress for older adults who died by suicide. More than half of the older adults who took their own lives had reported experiencing financial problems as a significant source of stress in the six months leading up to their deaths.
The Distressing Numbers
According to a story by the Population Reference Bureau, here in the United States, three times as many women as men have reported a history of attempted suicide, yet men are four times more likely to die by suicide. The choice of method may influence this gender disparity, as white men tend to use more violent and lethal means compared to other demographic groups. In 2001, 73 percent of all suicide deaths and 80 percent of firearm suicide deaths were among white males.
The study also found that suicide rates among elderly males also vary significantly across ethnic groups. Compared to white males aged sixty-five and older, African American, Hispanic or Latino, and Asian or Pacific Islander males in the same age range had notably lower suicide rates.
As men age, the gap in suicide rates between black and white men widens. In the 45-64 age range, white males commit nearly three times as many suicides as their black male counterparts. This gap continues to grow among those aged 75-84.
The article concludes by stating that the risk of suicide increases for white elderly males as they age. White men aged eighty-five and older have the highest annual suicide rate of any group, whereas the highest rate for white women peaks between ages 45 and 64.
Risk Factors and Warning Signs
Suicidal thoughts in older adults may be linked to a variety of important risk factors and warning signs. These include:
Depression - Characterized by persistent feelings of sadness, hopelessness, and worthlessness. It can impact a person's ability to handle daily activities and affect their relationships and overall well-being.
Previous Attempts - Has the person attempted suicide before? This could include any previous incidents of self-harm or suicide attempts. It's important to consider the history of prior suicide attempts when assessing an individual's risk factors.
Persistent Negative Mood - The individual experiences a persistent and overwhelming sense of hopelessness and a profound disinterest in making future plans. This includes a pervasive feeling of despair and a lack of enthusiasm for activities or goals that were previously enjoyable or meaningful.
Loss - Experiencing a sense of loss of independence or purpose: Dealing with adjustments in responsibilities and grappling with a diminished sense of purpose or significance in daily life.
Medical Conditions - Medical conditions that significantly limit functioning or life expectancy may include chronic illnesses or conditions that substantially impact daily activities and overall quality of life.
Cognitive Impairment - Impulsivity stemming from cognitive impairment can manifest as alterations in an individual's reasoning and decision-making capabilities. This may lead to impulsive behaviors and difficulty in making sound judgments and decisions.
Social isolation - This refers to a state in which individuals have limited contact with others and experience feelings of loneliness. This can occur due to various factors such as physical distancing, lack of social support, or decreased social activities. Social isolation can negatively affect mental and physical well-being, and it is important to actively address and counteract these feelings through various means, such as connecting with others through technology, engaging in hobbies, and seeking support from friends, family, or mental health professionals.
Relationship Stress - During challenging times such as family discord or experiencing losses such as the recent death of a loved one, it's common to encounter strained relationships or deal with the emotions of recent bereavement. Acknowledging these difficulties and seeking support when navigating such tough experiences is important.
Refusing to Change - An inflexible personality or difficulty adapting to change can manifest as resistance or an inability to cope with life changes and challenges. This may result in feeling overwhelmed or distressed when faced with new situations or unexpected circumstances. It can also lead to difficulty adjusting to changes in routine or environment.
Lethality - Access to lethal means (i.e., firearms, other weapons, etc.): Easy access to items that can be used for self-harm.
Risky Behaviors - Daring or risk-taking behavior involves participating in activities that threaten personal safety without considering the potential consequences.
Personality Changes - You observe pronounced alterations in an individual's behavior, mannerisms, or emotional state.
Substance Abuse - Dependence on alcohol or medication can occur because of misuse or abuse, often functioning as a coping mechanism. Remember, seniors have access to many medicines, which can be abused but also used as a means for a suicide attempt.
Verbal Threats - Verbal suicide threats, such as, "You'd be better off without me" or "Maybe I won't be around," are expressions of hopelessness and self-deprecation and are often referred to as passive suicidal ideation. These statements can indicate that the individual is experiencing severe emotional distress and may be at risk of self-harm. It's important to take these statements seriously and offer support and assistance to those expressing these thoughts.
Giving Away Possessions - Disposing of cherished possessions is a symbolic act of preparing for the end, whether that may be the end of a chapter in life or the end of life itself.
Supporting Someone with Suicidal Ideation
When dealing with an older adult who is contemplating suicide, the 988 Suicide & Crisis Lifeline outlines five crucial action steps you can take to provide support and assistance.
Ask. Don’t be afraid to be direct with the person at risk. Ask questions like, “Are you thinking about suicide?” and “How can I help you?” to initiate a conversation in a supportive and unbiased way. Be sure to listen carefully to their answers and acknowledge their emotional pain. Help the person stay focused on why they should want to keep living.
Be there. If you can, be physically present for the person to ease feelings of isolation and provide a sense of connectedness. If a face-to-face visit is not possible, be there for them via phone or video calls. Work with the individual to identify others who may be willing to lend their help. Be sure not to make any promises that you are unable to keep.
Keep them safe. Find out if the person has already made any attempts on their life. Do they have a specific plan or timing in mind? Do they have access to their planned method of self-harm? Learning the answers to these questions can help you understand whether this individual is in immediate danger. In general, the more detailed a person’s suicide plan is, the higher their risk. Someone who is at imminent risk for suicide may require more intensive intervention. The 988 Suicide Lifeline can serve as a valuable resource for helping you determine the next steps.
Help them connect. If a senior in your life is thinking about suicide, it’s important for them to establish support systems they can rely on now and in future moments of crisis. This includes suicide prevention helplines such as the Lifeline, as well as resources available in their local community. Find out if the at-risk person is currently seeing a mental health counselor. If not, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a searchable, confidential directory of mental health providers across the U.S.
Follow up. Studies have shown that following up can reduce suicide-related deaths in high-risk populations. Once you've had an initial conversation with the vulnerable person and helped them establish a support network, make sure to check in.
A Final Thought
"It is imperative for individuals who are in close contact with older adults to remain vigilant for any indications of suicidal ideation and to take proactive measures to mitigate the risk of self-harm," stated Attorney Connelly. "Suicidal thoughts are often associated with underlying mental health conditions, particularly depression, and necessitate serious attention. If an individual expresses a specific intent to engage in self-harming behavior and is resolute in their decision, do not leave them unattended. Instead, it is essential to provide continuous support until professional emergency services are available to offer assistance."
Please note that the information provided in this blog is not intended to and should not be construed as legal, financial, or medical advice. The content, materials, and information presented in this blog are solely for general informational purposes and may not be the most up-to-date information available regarding legal, financial, or medical matters. This blog may also contain links to other third-party websites that are included for the convenience of the reader or user. Please note that Connelly Law Offices, Ltd. does not necessarily recommend or endorse the contents of such third-party sites. If you have any particular legal matters, financial concerns, or medical issues, we strongly advise you to consult your attorney, professional fiduciary advisor, or medical provider.
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