Suicide and Depression Among Elderly on the Rise

Kimberly Tyler Health Guide
  • Nearly eight decades of life brought to a violent end by a handgun. A handgun to the head. And a handgun to the head by a woman. Doesn't seem right, does it?

    Statistically, it does. Death by suicide in Americans aged 65+ occurs roughly every 90 minutes. Death by suicide in Americans aged 65+ accounts for 19% of suicides across all age groups.[1] Older Americans are also less likely to "fail" in death by suicide. Some of this can be accounted for by the preferred method of choice-firearms-used in 71% of these suicides. Although more men than women use a gun, this is a women's first method of choice as well.[2]

    Suicide is preventable. And I do realize that if someone is determined enough, it can still happen. Mental illness tears away healthy rationality and tricks the brain into thinking there is no hope, no reason to believe circumstances will change, and that the capacity to alter life circumstances is no longer an option available.

    However, I do need to state that if we choose to be accountable for one another, suicide rates do not need to increase. Patient expert on this site Christopher Lukas wrote about his uncle who asked for more sleeping pills and how he took action to get him treatment for depression and this uncle lived another ten years. We all know how prevalent stigma is regarding depression and thoughts of suicide. This is umpteen times stronger in the older generation of Americans. Merely speaking of "divorce" is still taboo for folks over 65. Mental illness barely hits the radar. Letting others know about mental illness, receiving treatment and talking about true feelings is essential to break this disproportionate ratio of suicide for older Americans.

    In my opinion, the suicide by Betty at age 76 did not have to happen. There were so many things she did not know the truth about, and this may have changed her perspective. Perhaps she knew these truths, and they sickened her like they do me. Then again, I really do not believe that to be the case, as I know-knew-Betty. She would not have taken garbage handed to her for all the world.

    I know that people think about suicide for years and know how they will do it; it is simply a matter of when. Many people who plan their suicide have their plan for years, and it only takes the smallest moment-a rude person, not making the light in traffic, a cap off the toothpaste-to set the plan in motion. I know that I will never know the full truth of all that was moving through Betty in that moment. What I do know is that I am sad that she felt such despair and hopelessness; I am sad that she felt the burn of physical pain prior to death. I am sad that I can not longer talk to her, hug her, love her, participate in life with her, get her opinion, and talk about what matters. She was a vibrant woman of wisdom and ahead of her time.

    Perhaps a friendship with a thirty-five year age difference may not make sense to others; for us, age was never an issue in our friendship. We were two peas in a pod. Many people would often mistake us for mother and daughter. After awhile, we stopped correcting them. Betty was a mother to me, and I want to believe I held up my end as a daughter. She never had children of her own, and she did tell me that I was more than her friend, as I would have been of the age if she had a daughter. She let me know I was loved unconditionally in no uncertain terms, and I know she knows I loved her the same way. That is what I hold on to. No regrets. We each knew we were both loved and cherished because we told each other this, and showed it in our actions.

    To my knowledge, the one truth Betty did not share with me was her plan for suicide. Her husband knew her plan, and her friend of forty years knew the plan. The husband did nothing with the information, and the friend thought she really wouldn't do it. The husband was educated in depression but the friend was not. The husband was in a rehab facility following a surgery and he was surrounded by psychiatrists, therapists and social workers. Her husband did not come home after his surgery because he was refusing to eat. A growth at the opening to his stomach needed to be removed, and he had not eaten for about a month, so the doctors understood he needed to be retrained to eat again. More than a month had passed and he was still not eating. Her husband did not make a phone call to her friend she went to visit, nor to me. He tells me I am family, yet he did not tell me she had a plan and was determined to execute it. In this moment, I am still angry at his inaction.

    Perhaps he had accepted her decision and thought he was being respectful. Betty was her husband's only caregiver for more than a dozen years and he knew she was exhausted. However, he also knew she was receiving therapy for depression and medication. He had access to support her, as well as the mental acuity to say, "My wife needs support." Her husband knows me very well, and one phone call to me would have changed the course-perhaps not forever: I am not God and I do not have the power over another. But I would have ensured Betty received the treatment she needed, and I know her husband knew that. He saw her happy, and when Betty and I became friends over four years ago, I know he was witness to Betty's propensity for being such a love in this world, and participating in a joyful manner. He knew she desired peace and rest, but it did not have to come at the cost of her life.

    What I did not know when Betty was in town was that she told her oldest friend her plan, and that she had no intention of "failing" and that her first attempt would be fatal. Betty also told this friend she was taking her final tour of the city, seeing her old house, and would be putting her dog down. The dog had strained his back, but this was not a life threatening injury to the dog. I am thinking this was enough of a reason to do it. I do not know for sure because I was not there. All of these are red flags for suicide and they were not recognized by her 80 year old friend (as she did not know these were warning signs). I do not blame her friend, as her friend did not know how serious Betty was.

    And then there's me. For all I know about mental illness, I did not pick up on anything when I had dinner with her. She did not share her plan, she did not tell me about putting her dog down or about her final tour of the city. We talked about her concerns with her husband, financial matters, government paperwork, and practicing self-care. We were very open with one anther. We created a strategy for forming a "phone tree" so that she would not need to make so many phone calls. We talked about our plan to go away for several days together after September when affairs were handled: we were going to sit on a beach and have a drink that required an umbrella. We have been talking about this and planning it for some time. She brought me a bouquet of yellow roses, something she had never done before. But this was not a tip off for me: Betty was a unique woman and she said she saw them and just picked them up for me. She was so tender and kind, and I was taken, as I always was, by her kindness, thoughtfulness and sensitivity. We went to our favorite restaurant as well. She introduced me to it years ago, and it was our secret hide-a-away to get away for a few hours to chat. We did this often before she moved a year and a half ago when she sold her home to pay for her husband's medical bills.

    I received a phone call on Thursday, July 5th, from a friend of hers-the executor of her will and financial planner-to ask me if I had heard from Betty since meeting her for dinner. This was one week and two days since I saw Betty. Betty and I talked often, but it was not uncommon for each of us to leave messages for the other on voicemail. Not hearing or talking to her in person for a week was normal. Apparently, Betty had not gone to see her husband since returning back home, and the husband called the executor to ask for help to find Betty. He did not call the friend Betty was visiting, nor me, but the executor.

    The executor called the police to go to their home. I received a phone call on Friday, July 6th from the executor that the police reported the day before that it appeared Betty had taken her own life at least six days prior. I was in shock. Seven/eight days back was June 27th, the day she arrived back home, the day after I saw her.

    As the days have gone by, I have garnered more information. I know now that her husband knew and that he was not surprised when the social worker told him what happened and when the police came to talk to him. He knew. He was waiting. Betty's body lay on the kitchen floor for six or seven days-he called the executor after six days of waiting.

    I have not gone down to see the husband since all this occurred. I honestly do not know how to see him and not be angry. I realize that Betty was feeling isolated, extremely worried about finances as every day that her husband did not eat was another $1500-$2000 of their savings, and that they were already close to halfway through the sale of her house for his medical bills before more paperwork began for Medicaid and the Veterans' insurance to kick-in. Further, her three year lease for the house they were renting was terminated because the owner wanted to sell in the spring, so Betty would have to move again. I do believe Betty reached her tipping point. Situational depression exacerbated her clinical depression. Betty did not suffer from physical illness. I am not angry at Betty. I understand. I am angry at the lack of accountability of those, particularly her husband, who were in a position to do something. I feel guilty about being angry at a 78 year old man. But I have not let this guilt move me to drive down to see him. The executor told me that when he saw the husband 48 hours after the news of Betty's death that the husband was in good spirits and eating full meals. I was stupefied. I know we all grieve in different ways, but this made no sense. In this moment, I do not know what to do with my anger except to talk to both my therapist and Pastor. My reaction is normal; for me, I know I need to breathe through this time before I see the husband. I will be working with the executor to get affairs in order. I will honor Betty in the best way I know how, because that is what matters.

    For more information about suicide risk with older Americans, two websites that may be helpful are: http://www.nimh.nih.gov/publicat/harmsway.cfm and http://mentalhealth.samhsa.gov/suicideprevention/elderly.asp

    [1]In 2004, this number was 14.1 per 100,000 deaths in this age group by suicide. http://www.nimh.nih.gov/publicat/harmsway.cfm CHMS National Strategy For suicide Prevention-A collaborative effort of SAMHSA, CDC, NIH, HRSA, HIS http://mentalhealth.samhsa.gov/suicideprevention/elderly.asp

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  • [2] CHMS National Strategy For suicide Prevention-A collaborative effort of SAMHSA, CDC, NIH, HRSA, HIS http://mentalhealth.samhsa.gov/suicideprevention/elderly.asp

     

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Published On: July 14, 2007