Main image courtesy of IRT.

Sadly, suicide is a major concern for people of all ages, for both men and women. In 2019 alone it was the 10th leading cause of death in the U.S. This makes it very clear that this is a public health concern, and that the healthcare system is not meeting the mental health needs of many people. This is even more true and concerning for the elderly, who as they age, are more likely to think about and act on their suicide attempt. 

But why is this occurring in older populations, and why do they tend to go through with their suicidal ideations at an alarming rate? In this article, we’re going to address this very real concern about elder suicide prevention, and how addressing mental health and prevention strategies could possibly help decrease the amount of elder suicides.

Specifically we’re going to discuss:

• Why elder suicide is prevalent
• The risk factors involved with elder suicide
• Whether or not there are warning signs when a senior is suicidal
• How staff in long-term facilities can help prevent suicidal situations

Mariposa Training offers courses on this important topic, giving care providers access to crucial training in knowing the risk factors of their residents.

Why is Elder Suicide So Prevalent?

Why are seniors so susceptible to suicide?

There are many reasons seniors may contemplate suicide, but the most common is loneliness. Image courtesy of iStock. 

Although suicide and suicidal thoughts can affect younger people as well as adults, it can be very prevalent in the elderly. This is especially true for while males over the age of 85. Although there may be more suicidal attempts in younger people, seniors tend to go through with their suicide at a greater rate. Seniors are completing suicide at a higher rate because they tend to have access to more lethal means (prescription pills), are at a higher risk of isolation, may not be found in time, and their bodies are more frail. This means that even if they are found, their body may not recover from the attempt. 

There are a few factors that may explain why suicide is higher in elderly adults, but typically the number one reason for it is loneliness. Whether they live by themselves or in a long-term care facility, many seniors feel isolated and alone in the world. If they have watched the death of their spouse and other friends and family, loneliness can be especially difficult to deal with when you’re all alone. There are additional factors that can explain why elder suicide is so prevalent:

• Grief. Grief and the pain of losing someone close to them is a very real thing that seniors deal with. Sometimes it can feel as if the grief will never end, or that there’s no more point in living if they’re going to be alone for the rest of their lives. Seniors dealing with grief may also start to contemplate their own mortality, and start to wonder about suicide. This is why mental health checkups and interventions can be so important for someone dealing with loss and grief.

• Loss of independence. Another major reason seniors start to think about suicide is because as they age, they may start to lose their independence and freedom. Everyone wants to be as self-sufficient as they can, and it may be difficult for seniors to accept the help they need to complete daily tasks such as grooming, bathing, and dressing. If they are living in a long-term care facility, they may miss their home, or miss being able to complete errands on their own. 

• Illness/pain. When a senior is dealing with pain or mobility issues, it can sometimes be hard for them to not feel as if their quality of life has decreased. Chronic conditions may make it hard for them to move around and stay active, and pain may only be manageable with the help of medication. It may also be hard for them to deal with their loss of hearing, or vision, making it more difficult to interact with the world.

• Decrease in cognitive ability. If there has been a decrease in cognitive functions, this can also be the reason why a senior may be more likely to commit suicide. Depending on the cognitive condition, they may be more impulsive and likely to act on what they’re feeling in the moment. 

• Burden issues. The elderly sometimes feel as if they’re a burden to their family, especially if they aren’t able to visit often. They may also feel like they are a burden to the staff, who help them complete tasks they used to do with no problem.

These are all valid factors that can contribute to the high numbers of seniors committing suicide. It’s easy to see based on these variables how important mental health is, and when there is a lack of this kind of care, it is easy for seniors to fall into depression and suicidal ideation. 

What Are the Risk Factors Involved with Elder Suicide?

Some seniors are at a higher risk of suicide than others

Knowing the risk factors of seniors can help determine which ones are more likely to attempt suicide. Image courtesy of iStock.

As we mentioned earlier, there are a few factors that can explain why suicide is higher in elderly populations, such as grief, pain, and loss of mobility. However, there are also risk factors that personally apply to each senior, which can determine whether or not they’re at a higher risk than others of their age group for suicidal thoughts.

Demographics play a role

Men are more likely than women to think about and act on their suicidal thoughts. This increases with age, and if they are alone or have lost their spouse. Although suicide rates for both men and women over the age of 45 is the greatest, it is white men over the age of 85 that have the highest rate of completing their suicide. This means that older men living in long-term care facilities may be at a higher risk than their female counterparts. 

The personal history of the senior

In determining the risk of suicide, it’s also important to include the personal history of the senior. It may be helpful to determine whether or not they have experienced prior suicide attempts, or if a member of their family died by suicide. Their risk should also take into consideration their mental health, and whether or not they have reported depression in the past. Is there a family history of depression or mood disorders? All of these can be used to determine the risk level of suicide.

Their medical conditions

Seniors that are dealing with medical conditions such as incontinence, loss of mobility, illnesses, or are in pain are at greater risk to develop depression as a result. If they have a history of mental illness including depression, this can put them at an increased risk of suicide. Knowing the mental health history of a senior resident can go a long way in knowing how to respond to any behavior changes or warning signs of suicidal thoughts.

Family and social relations

The lack of friends or family can create feelings of isolation and loneliness, even among residents who share space at a long-term care facility. Needing more care and dealing with a loss of independence means that seniors aren’t able to participate in activities the way that they used to. The lack of involvement or contact with friends and family, and in addition to feeling like a burden, can contribute to suicidal ideation. 

Are there any barriers preventing suicide?

Although each senior resident can be scaled against these risk factors, there may also be barriers preventing them from acting upon their suicidal thoughts. This could include:

• Moral objections or fear
• Family members they’ll leave behind
• Anything that may need their care, such as an animal or plant
• They’ve undergone some mental health treatment

These are all reasons for living, and with additional mental health guidance, more senior residents could see that their life is worth living. Mental health plays a large role in mitigating these risk factors, however, staff should be aware of some warning signs that a senior could be contemplating suicide.

Are There Warning Signs When a Senior is Suicidal?

Know the risk factors and warning signs of elder suicide

It’s important to know the warning signs of suicidal thoughts in seniors. Image courtesy of Nurse Registry. 

It’s important for long-term care facility staff to know the suicide risk factors pertinent to each of their patients. This can help them identify who is or is not at a greater risk. Keep in mind however, it’s important to keep an eye out for warning signs from even lower risk individuals. The warning signs that a senior is not in a good mental health space and could be contemplating suicide include:

• A deepening of depressive symptoms
• Being preoccupied with the discussion of death
• Writing out their will
• Giving away possessions
• Wondering out loud how things will be when they’re gone
• Resisting care and being neglectful of themselves

You should not just brush these signs off lightly, as they may be the result of a senior’s worsening mental health. It’s okay to ask a resident who is engaging in these types of behaviors if they have been contemplating hurting themselves. It’s always better to err on the side of caution and to alert a qualified professional to evaluate what the reason is that the resident is engaging in these kinds of behaviors. 

How Can Healthcare Staff Help Prevent Suicidal Situations?

There are ways staff can help prevent elder suicide

You can make a difference in the lives of seniors by helping them engage in activities that are important to them. Image courtesy of Health Central.

As a staff member in a senior care community, you interact with residents each day, and can gain valuable insight into how they’re feeling. You can also determine if there have been changes in their mood, outlook, or behavior. These should all be documented so if there is a noticeable pattern, they can receive the appropriate intervention before it is too late. However, it’s important for staff to help prevent suicidal tendencies or thoughts by working on ways they can change their outlook and behavior, and by getting at the heart of the issue before it needs to turn into an intervention. 

Know that a senior’s mental health is key

The importance of senior mental health cannot be stressed enough. Although there are checklists and evaluations for the resident’s depression scale, that may not be enough. Depending on their answers, you can recognize whether or not a patient has risk factors for suicide, and if they have exhibited any of the warning signs. This should lead you to seek out the help of a mental health professional who can do an evaluation of the senior resident. By taking their answers to your questions seriously—and taking the time to thoughtfully listen to their responses—you may be able to improve the outlook of a potentially suicidal senior. 

Focus on ways to empower them

Many seniors have a hard time dealing with pain, their loss of independence, their limited mobility, dependence on care, or the loss of loved ones. Instead of focusing on that, as a staff member you can help them change their outlook, and focus on what they can control, and how there are many activities that can still provide them with meaningful engagement. This means finding out their interests and what brings them joy, and getting them involved. 

When it comes to care, allow them to do as much for themselves as they can. This can also give them back a sense of control, allowing them to make choices and decisions for themselves. 

Recognize signs and report them

If you see the signs of potential suicidal thoughts, it’s crucial that you document and report them. It’s better to report these tendencies or thoughts than to do nothing, and have it escalate into a crisis. 

Be patient and listen

Listen and see what really is bothering them—is it loneliness, pain, grief, or helplessness? When you give them time to speak and listen to their answers, you may just be able to get them the help that they need. Everyone wants to feel connected and engaged, and seniors especially. Staff members can be extremely helpful in getting them the attention and assistance that they need.

Elder suicide is a tragic fact and a public health crisis. However, there are ways that staff can help prevent this by knowing the risk factors, warning signs, and being aware of a senior’s mental health. Staff at long-term care communities can make a difference by listening and responding appropriately to the mental health needs of seniors. Make sure your staff is trained on this important topic with the courses available at Mariposa Training.