Expert Tips for Helping Suicidal Older Adults

(Podcast #009)

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In today's episode, I want to share with you how you can help a loved one who you worry might be at risk for suicide. I want to talk about an important fact that older men over 85 have the highest rate of suicide in the country more than any other age group.

I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging. Questions about mental health and wellness, changes in the brain like with dementia, relationships and sex, caregiving, and even end of life. Like I say in my therapy groups, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult or caring for one, you're in the right place. Let's get started.

May is mental health awareness month and may is also older American's month, so I'm making May all about mental health awareness for older adults. I mean this is the Psychology of Aging Podcast after all. So since it's mental health awareness month and older American's month, I have a free guide to help older adults stay mentally well during COVID. It's called the COVID-19 Wellness Guide for Older Adults and I'll link to it in my show notes, so go check it out.

Last week I spoke about depression in older adulthood and I gave you tips on how to help your older loved ones who may be depressed. Today I'm going to be talking about suicide and how to help older loved ones who may be experiencing suicidal thoughts or have suicidal concerns.

Disclaimer (02:01):

I want to give a disclaimer upfront that I will be talking about suicide and suicide prevention and in doing this I'm going to be sharing a story that was published in the New York times in December. I know that suicide is a very, very sensitive topic and so if this topic is triggering for you or is very intense for you, please consider whether or not it's healthy for you to listen to this particular podcast on this particular day. If you do choose to listen, please consider listening with a friend or calling a friend afterward. If you need to talk about it and process it.

A family story of suicide (02:44):

I want to start with a family story about suicide. This is a story that was published in the New York times in December and I'll be referencing it and linking to it in my show notes if you want to read the story fully, but it's a story about Richard and Alma. Shaver. Richard Shaver was 79 and Amish shaver was 80 they were married for 60 years. Alma shaver had dementia and Richard was her caregiver. Her dementia was advancing and the story goes that Richard also had his own medical concerns - Cancer- though I'm not sure that his family knew about that and one day Alma shaver was sleeping and he as best as I think they could tell, took her life and then laid down next to her and took his own life as well. Everybody who knew them thought that they were incredibly devoted. They started dating in the fifties they were married for 60 years. The shavers had three daughters. They say that it's not the ending they would have chosen, but they won't hold it against their dad. And then the article says that the death especially stung his daughters, they were accustomed to their mom not being entirely there. They never thought their father would soon leave too. I want to just remind you if you haven't heard my grief and loss during covert episode on ambiguous loss, that's exactly what this talks about. They were accustomed to their mom not being entirely there. That is ambiguous loss. That is a loss where the person is physically there but emotionally gone or cognitively gone or difficult to connect with. And then what the daughters are saying is that was a loss that they were experiencing, but that they didn't think that they would lose their dad too. And so that's another type of grief. And then a suicide is another type of grief. It makes it complicated. The daughter's also worried that in their father's final hours that he must have felt so alone. The daughters say that they feel implored to live their lives to the fullest, worried that they might also get dementia. There are a lot of questions that come up around suicide and older adults and around euthanasia and older adults. That will be a conversation for another podcast episode.

Suicide must be taken seriously in older adulthood (05:21):

In today's episode, I want to share with you how you can help a loved one who you worry might be at risk for suicide. I want to talk about an important fact that older men over 85 have the highest rate of suicide in the country more than any other age group. Suicide attempts in older adults are more likely to result in death than in younger adults. The reasons for that are that older adults plan more carefully and use more lethal means. They're less likely to be discovered and rescued and less likely to recover if the suicide is not fully completed.

If an older adult is suicidal, it's okay to ask them questions, like these (06:06):

If you are worried about an older adult who's suicidal, it's appropriate and important to ask some questions like, do you feel as though life is no longer an option for you? Have you had thoughts about your own death and dying lately? Well, you share those with me. Have you had thoughts about harming yourself? Are you planning to harm yourself or to take your life? What is your plan? Is there a gun in the house or a collection of pills? Are you alone very often or who's near you? Who do you rely on? Who do you trust? And if they do share information that's concerning, there are some things you can do to help.

What I want to say about asking these questions is I hear from a lot of people that they worry, but if I ask if somebody is suicidal, won't that put the thought in their head? And the answer is no. If somebody is not suicidal and you ask, they'll say something like, "Oh no, I would never take my life. I have so much to live for. I mean I don't like the way my life is going now, but I would never end it." Or you know, "I think a lot about death and dying, but I am not going to do anything." You know, "this is all in God's plan" or "I'm going to let fate decide". If somebody is suicidal, they might give you a different response. Like, you know, "life has been really hard for me" or "I don't know what it's all worth anymore."

What you can do to help an older adult who is suicidal (07:39):

And depending how severe or how serious their response, then there are some things you can do to intervene. You can help by removing weapons from the home. Of course in a state of emergency you just call 9-1-1and you also get yourself safe. But most of the time it's not at that level. Most of the time the person's in a place of contemplation and you can intervene by removing pills. Sometimes people will stockpile pills and then with the intention of overdosing on them and so you can remove the pills or lock them up. You can remove or lock up weapons or other means. You can also reach out to your loved ones, physician or mental health provider and let them know what's going on. If you're a long distance caregiver or long distance family member, you can call the police for a wellness check.

Even if you live nearby, you can call the police for a wellness check. You can also encourage the older adult to see their primary care provider or mental health provider and talk about these symptoms and ask for an evaluation for depression. Sometimes depression, and I spoke a lot about depression and the signs of depression last week, can trigger some suicidal thoughts. Sometimes depression can be a side effect of illness or medications and so you definitely want to have a physician review their medications and their medical problems. It also could help, not only to call the physician or the mental health provider but to go with your loved one to the doctor and express your concerns as well. Um, you know, you'll have to be mindful about how you do this. You don't want to overstep and impede on the relationship, right?

You don't want to be intrusive, but you also want to express concern. If you do have concerns about your older loved one and and suicide, if you're worried that your loved one may be depressed or suicidal, in addition to getting them to see their doctor, their mental health provider, here are some other strategies that you can do. You can offer support and understanding and be patient and encouraging. You know, you can express your concern and your empathy and compassion at the same time. You can help keep track of appointments and medications. Sometimes when people are depressed, their memory and concentration will change. And so they might need help with keeping track of that. You could help with transportation to doctor's appointments when they talk. You can make an effort to really listen and be there. Never ignore comments about suicide. Take them very seriously and share them like we were talking about earlier with your loved one's therapist or their doctor.

And then invite them out, invite them out for walks or outings or activities and remind them that with time and with treatment, depression does improve. And so last week I spoke about how effective treatment is for older adults with depression, it's incredibly effective. It's really important that we provide care to older adults who are experiencing depression and suicidality. It can get better. And this is where as a mental health provider, I really rely on family and community. I can only do so much, right? I can help, I can provide therapy, I can provide recommendations and resources and this is where family comes in because family is so essential and the community are so essential to keeping the older adult engaged and with transportation and going out for walks and outings and paying attention to the signs. You have a very important role in caring for older loved ones and in communicating with providers.

Get more resources and information about suicide and suicide prevention on my website (11:39):

So please take that role seriously. It's valued and it's important. If you are concerned about a loved one who's depressed and experiencing some suicidal thoughts, please head on over to my website for more resources on getting your loved one connected to mental health care. One of the best things that we can do is help older adults prevent depression by helping them live their best quality life by staying mentally well. And so to help do this, I've created a wellness guide for older adults and specifically in light of COVID, so it's called the COVID-19 Wellness Guide for Older Adults. Head on over to my show notes and there will be a link there. 

If you or someone you know is struggling with thoughts about harming yourself or harming others, please reach out to the National Suicide Prevention Lifeline at +1 800-273-8255 again, that number is +1 800-273-8255 there are counselors standing by and ready to help and yes, ready to help older adults.

Wrapping Up (12:45):

I know that this topic is a sensitive one and so if this topic has been triggering or intense for you, please consider calling up a friend or your therapist or if you need to even the crisis line. I don't want you to hold this information alone and all by yourself. If you're really overwhelmed or flooded or struggling, please reach out for support.

Subscribe & Leave a Review (13:10)

All right. If you liked this episode, be sure to subscribe so you'll be the first to know when new episodes are released and then leave a review. Subscriptions and reviews help people to find this show. In wrapping up. It's important to share that the ideas expressed in this episode are mine alone and that information shared does not take the place of licensed medical or mental health care. I'll see you next week. Same time, same place, lots of love to you and your family. Bye for now.


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