Tag Archives: Mental Health

Suicide and Older Adults – Risk Factors and Warning Signs

September is National Suicide Prevention Month. This year, World Suicide Prevention Day will be observed on September 10.  The following information will help readers understand risk factors and warning signs of suicide in older adults.  

Suicide is a serious public health issue and an immeasurable tragedy for the surviving families, friends, and communities. Many of us may not realize that older adults are at particularly high risk for suicide. According to the Centers for Disease Control and Prevention (CDC), adult males age 65 and up, were the group with the highest suicide rate in 2016. Older adults appear to have a unique set of factors that place them at high risk for suicide. 

Suicide is often related to mental health conditions, such as depression, anxiety, and substance use disorders; particularly if undiagnosed or untreated. A mental health condition alone; however, is not necessarily an indicator of suicidal behavior. It is estimated that over 50% of people who die by suicide do not have a known mental health condition. Furthermore, many people with diagnosed mental health conditions engage in treatment and are able to live full lives. There are many other risk factors in addition to mental health conditions, including: 

  • Brain injuries or disorders 
  •  Prolonged exposure to stress 
  •  Chronic pain 
  •  Life and role transitions 
  •  Access to lethal means 
  •  History of abuse or neglect 
  •  A family history of suicide 
  •  Previous suicide attempts 

After contemplating this list, we can see how several risk factors may be elevated for older adults, specifically the area of life and role transitions. Older adults typically experience changes in their function and the roles they serve in their family or community. They may also experience the death loved ones, health decline, and loss of independence. Older adults face unique challenges, including functional decline, fear or becoming a burden, and concerns about long-term care and loss of independence. 

Older adults are typically more isolated, more frail, more likely to have a plan, and more likely to use lethal means when attempting suicide; therefore, a suicide attempt is more likely to end in death for an older adult than for a younger adult. That being said, suicide CAN be prevented! Some of the warning signs include: 

  •  Marked change in behavior or entirely new behaviors 
  •  Increased use of drugs or alcohol 
  •  Feelings of hopelessness and/or helplessness 
  •  Talking about suicide or not wanting to live 
  •  Isolating from family and friends 
  •  Visiting or calling people to say goodbye 
  •  Giving away prized possessions 

If you observe these warning signs, or if you or someone you know is thinking about suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). 

Let’s observe National Suicide Prevention Month by increasing awareness and reducing stigma! 

Author: 

Dr. Gabriela Frederick is a Clinical Psychologist, with a geriatric specialization. She is a Certified Master Trainer for AGE-u-cate Training Institute and is dedicated to improving care and services for older adults. Dr. Frederick may be reached at Gabriela@AGEucate.com 

References: 

American Foundation for Suicide Prevention (AFSP) https://afsp.org/about-suicide/suicide-statistics 

Centers for Disease Control and Prevention (CDC): Data & Statistics Fatal Injury Report for 2016. https://www.cdc.gov/injury/wisqars/fatal_injury_reports.html 

Mental Health America (MHA) http://www.mentalhealthamerica.net/preventing-suicide-older-adults 

National Institute of Mental Health (NIMH) https://www.nimh.nih.gov/health/statistics/suicide.shtml 

Why Aging Well is Everyone’s Business

Having a sense of purpose and a community network in which to provide these avenues seems to be important for brain health, an important component of aging well. But aging well starts with more basic work.  Some of these include:

  • Stay positive
  • Get physically active
  • Get enough sleep
  • Eat well
  • Connect with other people
  • And take care of your spirit

Why is Aging well everyone’s business?

According to research from Mental Health America, the population of people over age 65 in the United States is projected to double between 2000 and 2030, from 35 million to 70 million. While mental illness is not an inevitable part of aging, and older people actually experience fewer mental health conditions (excepting cognitive impairment) as they age, approximately 6.9% of people aged 65-74 experience “frequent mental distress, and many experience mental health and substance use conditions associated with loss of functional capacity even though a formal diagnosis may not be justified. Anxiety and depression and the psychotic symptoms of dementia in all its forms must be addressed for people to age well, and MHA envisions a supportive, integrated system of both psychosocial and medical care that encourages people to meet such challenges as they occur.

Older people with mental health problems are a diverse population including:

  • people with lifelong serious and disabling mental illnesses;
  • people with Alzheimer’s disease and other forms of dementia (often with co-occurring episodic anxiety, depression, and psychosis);
  • people with severe depression, anxiety, and emotional and behavioral problems that contribute to high rates of suicide, social isolation, and preventable institutionalization;
  • people with less severe disorders that nevertheless limit their ability to age well; and
  • people who abuse substances, primarily alcohol and pain medications, but increasingly including people with lifelong addictions and those who use illegal substances recreationally.

As stated by Deborah Padgett in the conclusion to her Handbook on Ethnicity, Aging, and Mental Health, aging need not be a time of “irreversible decline and loss,” and depression and emotional distress can be mastered. She concludes: “Declines usually associated with aging are quite malleable and influenced less by aging per se than by a host of psychosocial and lifestyle factors such as stress, diet, and exercise. Among the [most important] psychosocial factors associated with successful aging are a sense of control and autonomy and social support.” So “positive aging” can bring about overall wellness for individuals, focused on their personal goals and current place of residence, social support system, and community. The primary method is by strengths-based therapies that build the healthy habits that MHA refers to as “wellness.” These strengths and supports are critical to aging well.

Still, nearly half of people over age 65 with a recognized mental or substance use disorder have unmet needs for services. Older adults with mental health or substance use conditions often do not seek specialty mental health care. They are more likely to visit their primary care provider– often with a physical complaint.  And though treatment can be an important component of aging well, misdiagnosis, especially by non-specialists, is a significant concern, as is an overreliance on drugs rather than psycho-social treatment. The interaction among physical, emotional and behavioral conditions is complex in older people.

Aging well may seem simplistic in practice, but for society at large, we must integrate collaborative initiatives among public and private sectors that offer multi-level approaches to reaching our aging adults and their families with education, resources, and support.   Eldercare providers, aging and mental health public service organizations, faith communities and member associations must prioritize this agenda as we enter an era of extreme aging.

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  Pam is the creator of the internationally recognized Dementia Live Simulation experience, helping caregivers to understand first-hand what life with dementia might be like.   This program is transforming training for law enforcement, first responders, healthcare and long-term care professionals and families and anyone who works with aging adults and their families.  

http://www.AGEucate.com