SUICIDE RISK AND THE ELDERLY

Dr. Astrid Staley, DMin MST, MA Min & BA Min HBC

Australian statistics as to the number of people who die by suicide swell to alarming figures of over 2,000 people per year with three quarters being males. This shocking number, higher than the national road toll, is generally associated in the media with youth and those below retirement age.

However, there is a forgotten people group those between 65-85 years of age who seemingly go unnoticed and underreported.

Whilst they slip under the media radar, suicide amongst the elderly inflicts a greater toll on human life, over other age groups. The elderly in our community are considered high risk to suicide death due to the multiple challenges faced in this stage of life.

The Christian community versed in the challenges faced by the elderly, are positioned to offer care that restores courage and hope in a time of life where courage and hope has grown dim. This response by the community is effective prevention and intervention.

Within a church context, where the sixty plus age demographic is overlooked, and the church remains ill-informed as to challenges faced in this stage of life, they unwittingly contribute to the tightening grip of hopelessness and the loss of courage to face what might lay ahead felt by this people group.

The prospect of facing the twilight years with a significant level of dependence upon caregivers, frequently strangers, is not welcomed as in the dawn of life. The inevitable march toward this point are littered with many challenges, recognized as precursors to suicide, leaving those 65 years of age and beyond at times looking to suicide as a way of resolving the pervading sense of hopelessness.

It is beneficial for the Christian community to be informed as to risk factors, warning signs and triggers common to the elderly, to promote a proactive approach in alleviating these triggers, and in so doing, provide effective prevention and intervention for this group.

Age group (yrs)

Males no.

Females no.

Persons no.

Males rate

Females rate

Persons rate

5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 and over All ages

30 1,125 1,674 1,973 1,718 1,120 601 483 187 8,911

23 362 455 564 550 370 176 122 66 2,689

53 1,487 2,129 2,537 2,268 1,490 777 605 253 11,600

0.4 14.0 21.4 25.3 23.1 18.2 15.8 22.0 29.3 16.3

0.3 4.8 5.9 7.1 7.2 5.9 4.4 4.5 5.3 4.9

0.4 9.6 13.7 16.1 15.1 12.0 10.0 12.3 13.5 10.6

Age #1 group NSW (years) no.

5-14 14 15-24 298 25-34 545 35-44 666 45-54 611 55-64 408 65-74 250 75-84 182 85 and 85 over All ages 3,059

#2 QLD no.

14 390 513 609 515 342 170 125

#3 VIC no.

12 336 460 561 544 343 174 138

#4 WA no.

5 227 286 314 292 174 81 63

#5 SA no.

0 119 171 231 179 140 61 53

#6 TAS no.

3 31 66 68 76 50 22 24

#7 NT no.

5 68 50 47 21 10 10 7

#8 ACT no.

3 18 38 41 29 23 9 13

Total AU no.

53 1,487 2,129 2,537 2,268 1,490 777 605

61

46

24

17

16

0

3

253

2,740

2,614

1,466

971

355

218

175

11,600

Age #1 group NSW (years) no.

5-14 14 15-24 298 25-34 545 35-44 666 45-54 611 55-64 408 65-74 250 75-84 182 85 and 85 over All ages 3,059

#2 QLD no.

14 390 513 609 515 342 170 125

#3 VIC no.

12 336 460 561 544 343 174 138

#4 WA no.

5 227 286 314 292 174 81 63

#5 SA no.

0 119 171 231 179 140 61 53

#6 TAS no.

3 31 66 68 76 50 22 24

#7 NT no.

5 68 50 47 21 10 10 7

#8 ACT no.

3 18 38 41 29 23 9 13

Total AU no.

53 1,487 2,129 2,537 2,268 1,490 777 605

61

46

24

17

16

0

3

253

2,740

2,614

1,466

971

355

218

175

11,600

Table 3: Risk Factors/Cumulative Losses decline in mobility; decline in energy levels; disability; cognitive changes; medication dependence; motor abilities affecting balance; eyesight, hearing; brittle Physical bones; loss of teeth; sleep disturbance; digestive disorders; loss of appetite; phantom illnesses; loss of bladder & bowel functions; prostate cancer; mastectomy changes in brain chemistry; physical decline or organic mental decline; chronic pain; chronic illness; impaired immune responses psychological effect to loss of spouses and friends; sense of an having lived an unfulfilled life; decreased ability to cope with change; psychological effects of chronic illness; disability & dependence; psychological effect of leaving the work Psychological force and retirement; sense of worth in society; psychological effect of facing death of self; lack of optimism; intolerance to aging process; alcohol or drug dependence; spirituality Biological

lack of independence & increased dependence on caregivers; status in society; Social financial challenges; poverty; isolation from the world due to loss of hearing or eyesight; place amidst peers

Table 4: Warning Signs & Triggers

recent bereavement of spouse; retirement; financial loss; negative health diagnosis; no sense of purpose; chronic illness, fear of being put in a care facility; facing Medium Risk surgery; disability; vision loss; dysfunctional family relationships; acute depression; sense of hopelessness; withdrawal from support networks; prior suicide attempts; inability to look for solutions putting affairs in order; withdraw from social networks; significant change in physical appearance i.e., lack of care about personal presentation; not eating; not sleeping; persistent depression; difficult interpersonal relationships; a combination of psychological, social and physical factors; recent bereavement of spouse; prior suicide attempts; extreme pessimism about life; a plan in place; means to carry out High Risk plan; visible despair in facial expression; continually worrying; feeling helpless; loss of interest in hobbies; aggressiveness; recovery ability from surgery; perceived burdensomeness Suicide Talk i.e., ‘life is not worth living,’ ‘no one would miss me,’ ‘I have lived a good life,’ ‘want to be with deceased,’ ‘I can’t live with this pain anymore,’ ‘I’m terrified about the future and what might be’

Attitudes toward aging are clearly critical in keeping the elderly connected not only to the community but also to God, both of which are effective prevention and intervention. The value of integrating the elderly into the church community cannot be underestimated. The benefits mutually enrich the community as a whole.

Building intergenerational bonds, providing spiritual mothers, fathers and grandparents for many fatherless and motherless younger generations. This in turn gives the elderly a sense of belonging and family, where perhaps their own family relations may be strained, or non-existent.

A sense of belonging is critical in effective prevention and intervention.

Elderly who volunteer in the church along with lowering death rates experience improved physical and mental health, higher levels of social support, deeper sense of meaning, greater sense of productivity, enhanced life satisfaction, improved selfesteem, expanded opportunities to express generativity ... sense of belonging and social connectedness, legacy, a sense of structure, purpose, identity ...

Keeping the elderly engaged in some form of voluntary ministry is effective

prevention and intervention.

AGE SPECIFIC RELATED PROGRAMS:

Terra Nova Films (DVD resources on the transitions in aging) http://www.terranova.org

NSW Department of Health "Suicide Prevention for Older People." www.health.nsw.gov.au GENERAL SUICIDE PREVENTION TRAINING PROGRAMS: Salvation Army, "Hope for Life." http://suicideprevention.salvos.org.au/ Focus on the Family, "Born Survivors." http://www.families.org.au Global Ministry, FREE VIDEO TRAINING. “A Theological and Practical Response to Suicide: Entering the World of the Suicide & the Bereaved.“ https://astridstaleyblog.wordpress.com/free-15-min-suicide-preventionvideo-training/

Education for the community and the elderly is a critical aspect of prevention and intervention.

Physical activity is critical in maintaining not only mental health but also maintaining mobility and connectedness and are effective prevention and intervention.

Golden Carers - offer activities, resources for caregivers, students, and recreation professionals: http://www.goldencarers.com/

Exploring Activities With The Elderly, a published

resource offering project ideas to do with seniors: http://vassedina75.wix.com/exploring-activities

"Alzheimer's Disease in-Depth Report." The New York Times, http://www.nytimes.com/health/guides/disease/alzheimers-disease/print.html "Causes of Death, Australia, 2011." Australian Bureau of Statistics, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/45BB0F6267E81515CA257B 2E000D7638 "Causes of Death, Australia, 2011." Australian Bureau of Statistics, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303 Appendix12011.

Puffer, Keith, A., & Miller, Kristi, J. "The Church as an Agent of Help in the Battle against Late Life Depression." Pastoral Psychology 50, no. 2 (November 2001).

Raphael, B., Clark, S., Waring, T., & Dougherty, M. "Suicide Prevention for Older People." NSW Department of Health, www.health.nsw.gov.au.

Accessed 15th April 2014 "Suicide and Multiple Causes of Death." Australian Bureau of Statistics, http://www.abs.gov.au/ausstats/abs@.nsf/Products/3309.0~2010~Chapter~S uicide+and+Multiple+Causes+of+Death Staley Astrid Blog resources: https://astridstaleyblog.wordpress.com/