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Suicide in Later Life

Charmaine Spencer, LLM

Reprinted from "Suicide" issue of Visions Journal, 2005, 2 (7), p. 12

Suicide among older adults is more common than many people think. According to Statistics Canada, in 1997, the rate of suicide for older adults was 12.4/100,000 (23.0/100,000 for men, and 4.5/100,000 for women over the age of 65). The seniors’ rate is slightly over the national average, though the rate for older males is significantly higher.

A strong indicator of suicide risk among older adults is when a person simply feels that life is no longer worth living. Some of the risk factors commonly associated with suicide in later life are:

  • increasing age (more common among older seniors, i.e., people ages 80+

  • being male, and especially, Caucasian male

  • being single or divorced, or living alone

  • having an alcohol use problem

  • poorly managed chronic pain

  • social isolation or closed family systems that do not encourage discussion or help-seeking

  • poor physical health or the belief that they are ill

  • hopelessness and helplessness

  • loss of health, status, social roles, independence, significant relationships

  • depression

  • fear of being forced to move to a nursing home

Ageism can play a significant role in suicide in later life. Some health care providers may erroneously assume that poor health, feelings of hopelessness, and depression are part of normal aging, or they may assume that depressed older adults cannot be helped.

In the United States the ratio of completed suicides for older adults is 1:4, compared to 1:25 in the general population. Older adults (especially those aged 85 and over) have the highest rate of completed suicides of any age group.7 There are several reasons why older adults die in their suicide attempts. These include:

  • frailty—it takes less of a prescription drug to cause death; also, injuries may cause more physical damage and there may be less ability to recuperate.

  • social isolation may make rescue less likely

  • older people tend to use more lethal methods (prescription drugs, gun shot, falling from a high-rise) and they often have stronger suicidal intent.

  • causes of death may be less rigorously investigated in older persons (some ‘accidental’ overdoses may not be accidents).

One half of older adults do not leave a suicide note. This may reflect suicide as a sudden decision made out of desperation, protection of family or religious concern. Some may not have anyone to whom they can leave a note, while others may no longer have the ability to express themselves.

Among adults at any age, the risk ratio of suicide for people with substance use problems or dependence is 5.5 times higher, compared to people without these problems.7 The relative risk of suicide is even higher for individuals with certain dependencies:

  • 10 times higher for people with opioid dependence

  • 30 times higher for people with dependence/abuse of legal drugs (prescription drugs)

  • 39 times higher for people using a combination of legal drugs and alcohol

Professionals, other service providers, and family members can help reduce the risk of suicide among older adults by being alert to the signs in later life and sensitively helping the older person access appropriate community resources. Help may include medication and counselling for depression, substance use counselling, grief counselling, and chronic pain management.

 
About the Author

Charmaine is a Research Associate with the Gerontology Research Centre and Adjunct Professor in the Department of Gerontology at Simon Fraser University

Footnotes
  1. Statistics Canada. (2005). Suicides, and suicide rate, by sex and by age group. Retrieved August 14, 2005, from www40.statcan.ca/l01/cst01/health01.htm.

  2. Conner, K.R., Beautrais, A.L. & Conwell, Y. (2003). Risk factors for suicide and medically serious suicide attempts among alcoholics: Analyses of Canterbury suicide project data. Journal of Studies on Alcohol, 64(4), 551-554.

  3. Préville, M., Boyer, R., Hébert, R. et al. (2005). Correlates of suicide in the older adult population in Quebec. Suicide and Life Threatening Behavior, 35(1), 91-105.

  4. Quan, H., Arboleda-Florez, J., Fick, G.H. et al. (2002). Association between physical illness and suicide among the elderly. Social Psychiatry and Epidemiology, 37(4), 190-197.

  5. Spencer, C. (2004). Suicide and older adults. Retrieved August 30, 2005, from www.agingincanada.ca/suicide.htm

  6. Waern, M., Rubenowitz, E., Runeson, B. et al. (2002). Burden of illness and suicide in elderly people: Case-control study. British Medical Journal, 324(7350), 1355-1358.

  7. Centre for Suicide Prevention. (1998). SIEC Alert #28: Suicide among the aged. Retrieved August 30, 2005, at www.suicideinfo.ca/csp/assets/alert28.pdf.

  8. Salib, E., Cawley, S. & Healy, R. (2002). The significance of suicide notes in the elderly. Aging and Mental Health, 6(2), 186-190.

  9. Centre for Suicide Prevention. (2003). SEIC Alert #51: Substance abuse in combination with other mental illnesses: Together, do they increase suicide risk? Retrieved August 30, 2005, at www.suicideinfo.ca/csp/assets/alert51.pdf.

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