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It’s a beautiful day. The sun is shining and the world is filled with possibility—for you anyway. But you are increasingly aware that your dad has not seemed quite himself of late. And as you left his home the other night you heard him say: “Life is just not worth living since your mom died.”

This morning, you started to think about it all. There is a nagging suspicion forming: Is it possible that Dad is considering suicide? It may seem so foreign to you—and to everything you have ever thought about your dad. Here are some things to consider that might help you understand what is going on.

Each year more than 5,000 people over the age of 65 commit suicide. Thousands of other older persons struggle with suicidal thoughts or serious depression. For everyone else, though, this is too often an invisible problem—until it strikes someone we care about.

Start with the facts. The incidence of suicide for elders is higher than for any other age group; the rate among persons age 85 and older is 50 percent higher than among young adults in their 20s. In addition, these official death statistics do not include other, uncounted elders who quietly end their lives by stopping food or medications.

Men are more likely than women to take their lives, white men in particular, but suicide occurs among both sexes and all ethnic groups. Conditions such as depression, physical illness, social isolation (living alone, being widowed or divorced), alcohol abuse, and worry about finances are common among the elderly persons who commit suicide.

Most elders who live in difficult circumstances do not attempt suicide. Indeed, in the short run, it is quite difficult to predict who is vulnerable to some “last straw.” Yet when elders do attempt suicide, they are more likely to succeed, in part because they use more lethal means.

Talk about it openly. If someone you love is talking about suicide, or expressing ideas like, “I don’t want to be a burden,” or “Life is not worth living,” listen and respond carefully. Repeat in your own words what you heard, and ask if you heard correctly. Be honest about your own feelings and express your love and concern. But don’t argue or list all the reasons why this person should want to live. The first step that you can take is to listen without judgment.

If you are concerned about your loved one, fear should not stop you from an open discussion of suicide. If there are warning signs and conversational clues, ask your loved one outright if he or she is considering suicide. Far from planting any ideas, your question may allow your loved one to escape the darkness of dread and silence. Your words can be simple and direct: “You have said many times in the last few weeks that life isn’t worth living, and I have noticed that you’re not eating like you used to. I’m concerned, and I wonder if you ever feel like hurting yourself or ending your life?”

If the person admits to having suicidal thoughts, it is then important to ask if they have given any thought as to how to carry them out. If they have a plan, be sure to consult a mental-health professional immediately. If there are firearms in the home, they should be removed if at all possible.

Take it seriously. Because suicide attempts are hard to predict, and because older people are more likely to carry out their plans, someone who expresses thoughts of suicide should be taken very seriously. It is not only a matter of the person’s own well being, but also the well-being of others who might be harmed in the attempt.

Although ideas about suicide are not a normal part of growing older, the prospect of a darkening future can make suicide seem attractive to some. These elders either feel hopeless about an unendurable life, or they altruistically fear being a burden to others. The playwright Florida Scott-Maxwell wrote from her nursing home, “Death feels a friend because it will release us from the deterioration of which we cannot see the end.” People with thoughts of suicide have profound matters on their minds that deserve a serious response.

Relieve isolation. Often it is our tendency to deny our worries when anyone we know struggles with mental health. If that is your inclination, don’t give in. If someone you know is struggling with suicidal thoughts, it is vital not to let them succeed in pushing people away. Rather, loved ones should draw near and attempt to keep the person connected to the world.

If weather permits, try to walk outside with your loved one. If there are family gatherings, make every effort to ensure that Grandpa comes. Movies and plays—even school plays—can provide good diversion and social stimulation. Think about ways your loved one could help someone else—by making something, cooking, reading to young children, or joining in prayer for someone else. Suggest that friends stop in for frequent visits, and seriously consider round-the-clock companionship until the mood improves and depression eases.

Recognize the signs of depression. The National Institute on Aging advises seeing a doctor if these common signs of depression last more than two weeks: an “empty” feeling, ongoing sadness, and anxiety; tiredness, lack of energy; loss of interest or pleasure in everyday activities, including sex; sleep problems, including very early morning waking; problems with eating and weight gain or loss; a lot of crying; aches and pains that just won’t go away; a hard time focusing, remembering, or making decisions; feeling that the future looks grim; feeling guilty, helpless, or worthless; being irritable; and, of course, thoughts of death or suicide.

Clinical depression can lead to suicide because it induces thoughts and feelings beyond an individual’s control. In the grip of unshakable despair and hopelessness, an elder may think of ending his or her life. More serious than a bout of the blues, the onset of depression in later life can be difficult to detect because it can be confused with signs of dementia or other health problems, or with the effects of medications.

The detection and treatment of depression is a matter for professional help. Begin the evaluation with the elderly person’s doctor, who may refer you to a geriatric psychiatrist or other mental health specialist. If you are not satisfied with the doctor’s attentiveness, seek other advice. There is a range of available therapies for clinical depression in older people. The condition is treatable, and elders are not too old to benefit.

Don’t blame yourself. Depression and suicidal thoughts in a loved one are not your fault. Nor are they something for which you should feel shame. For some older people, a quick accumulation of losses makes it difficult to achieve balance and maintain good mental health. Older folks can experience loss of work and meaningful activity, of physical health and financial security, of pets, even of a home. Most significantly, older people often experience a loss of companionship and intimacy when partners and good friends die.

Not all elders experience such drastic losses, and many who do still manage to avoid depression and suicidal tendencies. But those who find the thought of suicide an uninvited companion don’t necessarily choose it. Rather, the feelings creep up on them and they have little ability to withstand the anxiety or depression. These challenges do not mean that you have failed your loved one.

If you’re concerned that a loved one is considering suicide, the best and sometimes the only thing to do is to surrender to God your worries and concerns. Pray for the wisdom and grace to support your loved one, even though their behavior may push you away or make it difficult. In quiet moments of surrender, many find comfort in praying words from the Book of Psalms, such as Psalm 23 or Psalm 71.

By taking the concerns of our older loved ones seriously, trying to keep them connected to life, and getting them help when it’s needed, we can do our best to help them through what is often a temporary time of crisis. With God’s help, they may emerge to see life with new eyes of hope.

Peggy Ekerdt is a pastoral associate at Visitation Church in Kansas City, Missouri where she directs adult formation and marriage preparation, and serves as a spiritual director. Dave Ekerdt is a sociologist at the University of Kansas specializing in gerontology, and former editor of the Journal of Gerontology: Social Sciences.

Resources
Books: What To Do When Someone You Love Is Depressed by Mitch Golant and Susan Golant, New York, Holt, 1996. Mental Health and Aging by Michael Smyer and Sara Qualls, Malden, Massachusetts, Blackwell Publishers, 1998. Miss Rumphius by Barbara Cooney, New York, Viking Press, 1982 (written for children but inspiring for all ages).
Organizations: National Hopeline Network, 1-800-SUICIDE. National Aging Information Center, www.aoa.gov/naic/notes/suicide.html. American Association of Suicidology, 4201 Connecticut Avenue NW, Suite 408, Washington D.C. 20008, 202-237-2280, www.suicidology.org.

©2002 One Caring Place. All rights reserved. This content is licensed by One Caring Place.

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