Suicide in Older Adults - Essay Example

? Suicide and Older Adults Suicide rates are common among the older adults who are in the age group above 65 years. It is evident that cases of suicide among the elderly are associated with feelings of depression and hopelessness in life situations. This research paper focuses on understanding why suicide among older adults is prevalence more than other age groups. It is clear that the older population have been neglected in terms of understanding the problems that push them to suicide. The paper assesses the psychological, physical, and social risk factors that older adults face. It has touched on preventive and protective measures that have the potential to eliminate this problem in older adults. In this regard, reference of further research on this topic has been proposed as the way forward. Suicide and Older Adults Suicide in any given age is a misfortune to the individual, family, close friends, and even to the entire community. In United States, suicide is a serious health issue that claims more than 34, 000 lives every year and further, over a million across the globe. Despite the fact that young people and middle-aged adults comprise most of the suicide deaths, this problem is also dire among the older adults from 65 years of age. Suicide among the older adults has greater chances of success than in any other age groups. Many cases of suicide among the elderly are associated with feelings of depressions and hopelessness among others. These factors should not however, solely be used to determine the extent of suicide within the elderly population. In reality, the burden that suicide brings to families and the community at large cannot be overemphasized. There is a need to undertake the necessary research to understand suicide and risk factors such as depression and methods that can diminish the rate of suicide among the elderly group (Pearson, Conwell & Lyness, 1997). In spite of the fact that suicide and its effects remains a priority issue in health care, suicide among older adults has largely been neglected and does not receive enough interest. Research indicates that suicide rates in most cases increase with age and the highest occurrences are witnessed among men. The idea that most elderly suicides occur from “rational” acts in reaction to irrevocable, understandable circumstances is not supported by any viable clinical study. It is evident that suicide among the older population is undertaken with stronger intent and with higher lethality that it is among the younger people. This is because health care practitioners and staff have enhanced methods of recognition and prevention of such cases among the younger people. Most of suicide cases reported in the media focus on younger people while the older adults are largely neglected. Methods of dealing with suicide among the elderly have not been fully researched and therefore, most cases are not prevented (Conner, Conwell & Duberstein, 2001). Acknowledging and recognizing the complexity of suicidal behavior among the older people, creates an important structure in appreciating effective methods to base for its prevention. This reviews the proof for factors that threaten older adults to suicidal problems and therefore, protect them from it. It is imperative that the public health and stakeholders realize that suicide is a developmental process in which risk and preventive factors play a role in defining the flight of suicide with time. It calls for identification of opportunities when to intervene and prevent such tragedies occurring among the elderly (Gerand, et al, 2006). Literature Review In 2010, it was estimated that about eight thousand six hundred and eighteen old adults died in suicidal circumstances. It has been disclosed that prevalence rates of suicide attempts do not reduce with increasing age, but instead cases of completed suicides are higher with age for both men and women. For instance, in United States it is evident that suicide rates among women become higher at midlife and remain constant thereafter, while for men the rates increases intensely with age. This risk is largely huge for white men with peaks for African American witnessed in young adults but rise at older age. Asian Americans have higher suicide rates like white men while Hispanic persons have a mid-range in their cases. It is evident that older men have over seven times more suicide cases compared to older women. Further, married older adults have lower cases of suicide compared to single, divorced, or widowed elderly individuals (Conner, Conwell & Duberstein, 2001). While older adults are less likely to be rescued during suicide attempts, firearms are the most common weapons they use at 67% rate while poisoning is at 14 % and suffocation 12%. It is important to note that older adults are most likely to use a firearm for suicide than adults below the age of sixty. This suggests that most cases of older adults’ suicides are lethal and most successful than for other age groups. In addition, most cases of attempted suicides among older adults result in a successful second attempt to end one’s life (Conner, Conwell & Duberstein, 2001). Besides the demographic features, risk and preventive factors for suicide among the elderly have been researched in recent times. This has been achieved through a series of systematically demanding, case examined psychological autopsy (PA) findings. In this respect, a major cause of suicide among older adults is indicated as psychiatric illnesses like depression and personality characteristics. This research argues that psychiatric illness is a major cause of 71% to 97% of suicide cases with affective disorder being predominant. Depression is closely related to this problem while common psychotic illnesses cited include schizophrenia, schizoaffective disease, delusion, and anxiety to a lower extent. Substance use influence suicide at a lower rate while most PA studies indicated that dementia did not appear as a risk factor (Reynolds, et al, 2006). It is evident that older people with depression have lower cases of depersonalization, low libido, and suicidal thoughts compared to younger age group. Research conducted indicated that elderly people above eighty five years and with a mental disorder easily indicated feelings of suicide at 30% while only 4% of the mentally fit claimed they wished to be dead (Cooley, et al, 1998). A part from psychiatric illness, physical problems, and functional impairments has largely contributed to risk of suicide among the older adults. It is evident that old people with malignancies have two times higher chances of committing suicide than those who do not have this condition. Other illnesses like HIV/AIDS, epilepsy, Huntington’s illness, multiple sclerosis, heart, spinal cord injury, renal and peptic ulcer conditions have greater effects in triggering suicidal thoughts. The average rate of suicide from these conditions is estimated at 1.5 to 4 times higher in most cases. In instances, where the relative threat of committing suicide in relation to any particular condition is minimal, higher cases of severe and prolonged problems heighten the risk. Older people who have not been diagnosed of any conditions have lower chances of committing suicide than those who have been diagnosed (Gerand, et al, 2006). Further, research by (Conwell, Orden & Caine, 2012) showed that outside the number of disorders diagnosed, the common perception about such conditions on function, discomfort, and threat of dependence on others encourage suicide. For instance, there are findings that older individuals found with an impairment that prevented continuation of normal daily activities were prone to suicide. Despite the fact that studies do not show any relationship between pain and suicide among the older people, it is imperative to examine this scenario in detail. This is because certain cases indicate that; old men in severe pain mainly result in self-harm, compared to women at a similar age. In this way, physical illness and disability is a big threat to older adults while the risk increases in combination of other problems (Gerand, et al, 2006). Social factors have been seen to pose a risk to older adults like stressful life and isolation. Research shows that stressful life events before death occurs are most common cases of fatal suicides in elderly people. Other common causes of suicide include aging, ill health, disability, grief, broken relationships, and lack of social support. The death of relationship and financial problems are triggers of fatal suicides among the elderly. Others like family disharmony and employment changes have largely caused suicide for older people above fifty years to increase. In this way, it is evident that social unity is crucial in an effort to understand and prevent suicides among the older people. The Centers of Diseases Control cited that strong connectedness at a personal, family and community level is significant is eliminating acts of suicide at all ages (Lebowitz, et al, 1997). PA findings have indicated that older people are not likely to commit suicide when one has a confidant, lives with peers in the community, has active social life, a hobby, and has community engagements. In this way, the findings indicated that older adults with family confidants and friends were less likely to be involved in acts of suicide. These results were emphasized by evidence that unsatisfied belongingness and supposed burdensomeness causes older people to desire death. Social isolation is a serious problem that causes people to feel unwanted and a burden to others in the society. This scenario brings feelings of suicide and most cases attempted suicide that easily succeeds (Conwell, Orden & Caine, 2012) It is also clear that social connections that contribute to a person’s feelings of belonging bring positive results. When there are relationships that truly bring a feeling of being wanted, they contribute to the need to live and therefore, such connection is protective of suicide attempts. This is why perceived burdensomeness is bound to encourage suicide from older people compared to other groups. There is research that cites that spirituality, religiousness is effective in eliminating cases of suicide among the old, and this can be because of the connectedness that is instrumental in being engaged. This also supports the fact that older women are less prone to suicide compared to men since they have spiritual or religious connection that brings a sense of belonging (Conwell, Orden & Caine, 2012) Other factors that contribute to suicidal risks include low Openness to Experience (OTE) and increased Neuroticism. Decreased OTE means a state of emotional and hedonic reactions, confined choice of interests, and a high preference of familiar than new. Psychologists indicate that older people with low OTE are bound to suffer suicidal cases because they are not prepared socially and psychologically to deal with issues that occur with age. These people are bound to be distresses and suffer setbacks in life. Neuroticism is associated with genetic irregularities within the central nervous system that cause people to act irrationally. These people are forced to behave impulsively and aggressively in circumstances of dysphoria, hopelessness, and evidently, they become suicidal (Conwell, Orden & Caine, 2012) Assessment of Risk Factors It is clear that the act of suicide comprises various psychological, physical, and even social factors combined at a crucial time in a vulnerable individual. Methods of risk assessment ought to focus on these factors to generate effective antecedents to deal with the problem among older adults. It is evident a high- risk person can be said to be elderly male living alone, bereaved, with chronic health problems and even with concurrent pain (Conwell, Orden & Caine, 2012) Analyzing the risk factors is difficult because of creation of high false-positive estimates compared to low-level rate of completed suicides. There are no clinically proven instruments that have been developed to measure the scale of suicide rates among the elderly. Research indicates that most elderly suicidal cases do not indicate any intent compared to younger groups and this makes the process of detecting older adults difficult. It is also evident that protective measures are often ignored in older adults’ suicide research, but clinical findings indicate it is hidden due to impacts on family members and the perception on the sanctity of human life (Conwell, Orden & Caine, 2012) Prevention and Management of Suicide among Older Adults Dealing with suicide among the older adults requires a mixture of universal, selective, and indicated prevention approaches. Universal prevention is where the entire population of the older adults is considered for evaluation. This is plans that aims at completely eliminating the risk of suicide attempts among the elderly and enhance their health. This is achieved through dissemination of information and knowledge where their skills and those of health practitioners are developed. Government regulations, screening, and limiting access to firearms or other dangerous items to the elderly is effective (Bruce et al, 2004). Selective prevention works by focusing on those with an increased risk of committing suicide but may not show the behavior. For instance, older people who have gone through life transitions like being put in a retirement home. Others are those who may have lost loved ones, those with chronic diseases, and therefore, they are vulnerable to suicide. A selective program enhances flexibility while reducing risk factors associated with suicide. An example is focusing on disabled, education on substance abuse, and addressing the effects of social isolation (Bruce, et al, 2004). Indicated prevention is a technique that works by focusing on screening the high-risk subgroup, or those that had attempted suicide before. This is would be accomplished through psychological, physical, and social knowledge that is known about suicide among the elderly. The high-risk older adults are those with depressive conditions, earlier suicide attempts, physical illnesses, and especially the socially isolated. Screening should be intensified among the elderly with multiple of the above conditions (O’Connell, 2004). In most cases, older adults do not volunteer that they suffer suicidal thoughts. Furthermore, these kinds of feelings may inhibit in elders with few depressive signs, and the thoughts may not be visible unless the individual is confronted directly. Healthcare practitioners ought to be trained and guided on how to investigate, and ask such questions. Primary care of depressed patients is necessary which includes family education, mental health intervention, and a support program. Depressed patients may not even respond to treatment and therefore, further treatment is required. This secondary treatment may involve psychosocial interventions and medications like antidepressants (O’Connell, 2004). It is clear from the research that suicide in older adults is prevalence because of serious problems of depression. This research supports this notion and further, indicates that many older people are vulnerable to depression because of conditions related to depression. The limitation from the study is related to lack of enough research on the issue of elderly suicidal problems. This area is largely ignored and most elderly people fall victim of depression and kill themselves. It is clear that this lack of in-depth research has contributed to highest suicidal cases to fall among the elderly group than other ages (Bruce, et al, 2004). Conclusion Suicide in older adults is common than in other age groups that have been examined across the world. The main cause of suicide in older adults is depression that is reinforced by other secondary conditions like anxiety, delusions, social isolation, and physical illnesses among others. Research indicates that the issue of suicide among the older adults has not been comprehensively addressed and therefore, this age group has most casualties of suicide. Further, it is clear that effective preventive method like dealing with depression in older people is crucial in eliminating this social problem. This research finding is crucial to social workers and other stakeholders to understand that suicide in older men need to be investigated, and addressed further. References Bruce, L. et al. (2004). Reducing Suicidal Ideation and Depressive Symptoms in Depressed Older Primary Care Patients: A Randomized Controlled Trial. Journal of the American Medical Association 291, 1081-1091. Conwell, Y., Orden, K., & Caine, E. (2012). Suicide in Older Adults. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107573/ Conner, K., Conwell, Y., & Duberstein, P. (2001). The validity of proxy-based data in suicide research: a study of patients 50 years of age and older who attempted suicide. II. Life events, social support and suicidal behavior. Acta Psychiatrica Scandinavica 104, 452–457. Cooley, S. et al. (1998). What Practitioners Should Know About Working With Older Adults. American Psychological Association 29, 413-427. Gerand, L. et al. (2006). Suicide In Older Adults: Nursing Assessment Of Suicide Risk. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864075/ Lebowitz, D. et al. (1997). Diagnosis and treatment of depression in late life. Consensus statement update. Journal of the American Medical Association, 278, 1186-1190. O’Connell, H. et al. (2004). Recent developments: Suicide in older people. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC523116/ Pearson J., Conwell Y., & Lyness, J. (1997). Late-life suicide and depression in the primary care setting. New Directions for Mental Health Services 76, 13-38. Reynolds, F. et al. (2006). Maintenance treatment of major depression in old age. New England Journal of Medicine 354, 1130-1138. Read More