Elder Suicide

As mentioned by McInnis-Dittrich, aging is a natural occurrence that all people will go through and there are expected changes associated with aging such as changes in physical appearance, loss of hair, and wrinkles. What are not common factors of aging despite the popular belief, is disability and illness (2014). Just because one gets older does not mean they are destined to be disabled and or have chronic illnesses. Many factors play a role in the health of the aging individual. The psychological, biological, and their social environment must all be considered.

Taking a look into one of the categories that are being considered first, it is not hard to guess that the psychological characteristics is most often looked at. Sometimes it seems the older a person gets the more depressed they can become. Common reasons for this thought might be that elderly persons are just unhappy because they are not young anymore, they are at a point in life where their health is doomed to fail them, or simply because they believe the myth that most old people are not in good mental health and think that all elders are old and senile. As populations age across the globe, the psychosocial health of elderly people in different parts of the world call for special attention (Alice Ming-lin Chong PhD, 2008).

Depression is a serious mental illness which can greatly alter the way a person functions in their everyday lives. Depression can cause a multitude of things to change. People can experience a loss of appetite, loss of interest in the things that they may have once loved to do, always feel fatigued despite having an appropriate amount of sleep, they may begin to have feelings of hopelessness, thoughts of killing themselves, or have trouble focusing on things.

Recent studies have shown that elderly people are not always as happy as some would like to blissfully believe. Suicide rates amongst the elderly are at the highest of all age groups even when looking at other parts of the world. In terms of social health, a significant number of elderly people are single, divorced or separated, and this trend is likely to be an even bigger issue as time progresses (Alice Ming-lin Chong PhD, 2008). In 2002 the World Health Organization (WHO) released the first World Report on Violence and Health. Finding that acts of violence result in more than 1.6 million deaths per year, the WHO considers violence to be a global public health problem of pandemic proportion. Unlike other studies of violence, the WHO went beyond the more obvious reasons of violence such as war and homicide and included more sources of violence like child and elder abuse, domestic violence, sexual assault, and suicide (Gross, B., 2006).

An important psychosocial indicator for the suicide rate amongst the elderly paints a very altered picture of the mental health condition of elder people. The baby boomer generation, those born between 1946 and 1964, has had relatively higher suicide rates. It is anticipated that the rate of suicide in men and women will rise resulting in substantial increases in the numbers of senior citizens dying by means of ending their own lives (Cornwell, Van Orden, Caine, 2011). The WHO/EURO Multi-Centre Study on Suicidal Behaviors found that the mean suicide rate for those aged 65 and over was 29.3 per 100,000. Other aspects of suicide in the elderly also reveal a less than satisfactory situation. The ratio of attempted suicides to completed suicides is much lower amongst seniors than amongst younger adults. What this means is that there is a greater determination from the elderly to use more effective methods to end their lives, such as hanging, firearms and jumping from heights or in front of moving vehicles (Dumont & St-Onge, 2011).

Current Approaches

Although elder’s social isolation has been a topic of interest for public policies in the recent years, its prevention, specifically in relation to suicide prevention, has not inspired the interest of researchers, yet. It is said that those who are widowed or living alone with few social supports in place are at a particularly high-risk for suicidal ideation (McInnis-Dittrich, K. 2014). The relationship between chronic interpersonal difficulties and suicidal behavior can be explained in part due to the low perception of social support. The experience of strong affects, interpersonal struggle, and hostility in relationships may undermine the sense of social support in depressed elders, possibly leading them to contemplate or attempt suicide. Depressed elders with a history of interpersonal difficulties need to be carefully monitored for suicidal behavior (Harrison, K. E., Dombrovski, A. Y., Morse, J. Q., Houck, P., Schlernitzauer, M., Reynolds, 3., Charles F, & Szanto, K. (2010). It is imperative to look at the results from a literature review aiming to identify the actions in elders suicide prevention. From the numerous papers identified on elder’s suicide prevention, only a small number describe actions in suicide prevention, some of which are actions targeting individuals, with psychological, psychiatric or psychotherapeutic interventions.

Only a very small number of researches integrate the social environment as a way to prevent suicide. It is equally important to discuss the particularity of this field, the limits of an individual-centered approach, and the interests of community, and integrative interventions in the Social work profession (Salias, Veron, Lapierre, 2013). It is necessary to include a more wholistic biopsychosocial approach because examining only one aspect of the whole issue is simply not enough. Other studies indicate that specific factors in domains of psychiatric illness, social connectedness of the older person with his or her family, friends, and community, physical illness and functional capacity appear to influence risk for suicide (Cornwell, Van Orden, Caine, 2011).

Another approach to suicide prevention in older adults has come from a more physical perspective. One study demonstrates that exercise has been used to help treat depression. Although the study results are not exact due to the number of patients that had dementia, the study does show that exercise could potentially be more useful as a treatment if it were done on a more regular basis and consisted of a more involved routine (de Souto Barreto, 2013). Other approaches to treating depression include some type of measuring instrument. One that allows for depression to be measured in such a way to indicate how likely a person is to become depressed or determines the levels of severity for those who are experiencing depression already. More commonly, these types of measurements are thought of as a preventative measure to help with recognizing depression at an early stage as to prevent the onset of suicide. Some tests are administered by doctors, counselors, and other health care professionals. More professionals now are required to be aware of the warning signs and even more are now required to be mandated reporters.

Assessment is a necessary part of prevention and is a well-known approach. The purpose of a biopsychosocial assessment serves as a way to identify what ways to best support an individual. The second way an assessment can help is to serve as an educational process to alert both elder adult and support systems to the areas in the elder’s life that may cause more potential harm. During the assessment process, risk factors for depression such as being female, family history, physical illness, low income, and social isolation must be taken into consideration. Assessment for depression is critical and failure to do so can mean that depression is likely to go untreated. Untreated depression can lead to more of the reasons that elders feel the need to commit suicide (McInnis-Dittrich, K. 2014).

An individual approach for depression known as Cognitive behavioral therapy (CBT) has been known to be very effective when treating depression in elderly persons. Cognitive behavioral therapy is a form of psychotherapy or also known as the talking cure. It has been shown to be effective for many different types of psychological problems and has proven to be effective in many others as well. CBT has been used more with adults. There is a developing body of evidence of its usefulness in people with conditions that include depression, generalized anxiety disorder, obsessive compulsive disorder, eating disorders, self-harm and conduct problems. CBT treatment usually targets thoughts and behaviors. It encourages clients to challenge their negative thinking styles as well as their negative behaviors and instead find more positive ways to replace them. Clients are also encouraged to adapt to more realistic thoughts and learn better coping strategies (Scott, 2009). The thought is that once negative or maladaptive thinking has been replaced or changed, that the thoughts can then be followed by more appropriate action.

Propose Alternatives

Although I feel that current methods of treating suicide are not ineffective necessarily, I think that some of the suggested ways I read about for preventing, recognizing, and treating depression and suicide can be helpful. After researching, I would have to say that I have come to the realization that the primary methods of treating depression seem to mainly encompass some form of psychotherapy. I think that a combination of therapy in conjunction with medications have been proven to be most effective. Also, after all my research, I find that feelings or perceptions of being alone and being in isolation from different types of supports such as support from friends, family members, and peers have taught me that the elders social environment has a big influence for being a risk factor for depression and leading to suicide.

Treating depression is a preventative measure for treating suicide. Many who are said to have suicidal ideation, experience some form of depression initially. If we were to study over the number of people who have died due to suicide and were able to see how many were depressed before committing suicide, ultimately, we would wind up having looked at the risk factors as a way to treat depression. Considering risk factors for depression like having a family history of mental illness or suicide, substance abuse, isolation, feeling hopeless, and having readily available means to end one’s life such as guns, can be easily identified as social problems. Primary prevention of depression strategies through social and community inclusion was also said to seemingly be a promising field to look at more in depth and that it should also be part of a global strategy for social and health policies rather than an alternative to psychosocial interventions targeting depressed elders, who wish to commit suicide (Saas, Beck, Bodard, Guignard & du Rosco?¤t, 2012).

Despite the many different alternatives to treatment for depression, depression was still ranked by WHO as the third cause of burden of disease worldwide and projected that the disease will rank first by 2030. Numerous people will have their first experience with depression before they ever even reach the age of twenty (Malhi & Mann, 2018). The best alternative to treatment is prevention. Knowing what I know now about depression and its link to suicide, I think that early education is a good place to start. While treatments are helpful in various ways and some more than others, it is most important to make sure that the elder is included in his or her treatment process. Inclusion from start to end, knowing what is going to happen, and what can be expected will help the client to make an informed decision. It is likely to increase the rate of their participation. With the expectancy that elders have a choice in treatments and get to decide what is best for them, it can also be inferred that the number for suicide will decrease.

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