- Karen McPhail, RN, MSN., CDP
Mental Health Challenges and Suicide Risk in Older Adults: Sadly on the Rise
Sadly suicide is on the rise in older adults. Suicide is the 10th leading cause of death in the US and men over 85 and older have the highest rate of suicide in the country. Suicide in older adults is a serious concern and sadly loneliness, social isolation, lack of access to preventative health care, frailty, chronic pain, anxiety, and depression are all contributing factors that can increase an older adult’s mental health risk for suicide.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) and Administration on Aging (AoA), there are distinct signs that can point to a suicide risk. Unfortunately mental health is often not discussed during routine physician visits and wellness checks, so the subtle signs are often missed to the detriment of others.
Some of these signs based on their guidelines and my clinical practice may include:
Hopelessness, anxiety, and depression
Prior mental health challenges / suicide attempts,
Marked feelings of hopelessness,
Co-morbid general medical conditions that significantly limit functioning or life expectancy,
Pain and declining role function (e.g., loss of independence, control, cognitive changes, or loss of sense of purpose),
Social isolation and loneliness,
Dysfunctional family dynamics, estranged from family of origin, or other losses including the recent death of a loved one, partner, chronic illness, etc,
Stubbornness, inflexible personality, resistance to care, self neglect, or marked difficulty adapting to change,
Access to lethal means such as firearms,
Dysfunctional coping - alcohol, drug, or medication misuse or abuse, and judgment / impulsivity in the context of cognitive impairment.
Aging Life Care Professionals, also known as care advisors or geriatric care managers, have extensive knowledge and experience in these areas and can help individuals identify signs of suicide risk and assist in effectively and proactively navigating options and preventing escalation and tragedy.
The Aging Life Care Association surveyed its members concerning prevention of suicide in older adults. Of those surveyed, it was found that:
92% of respondents screen their clients for depression at every visit, or as needed/suspected
65% of respondents have worked with a client who has reported feeling suicidal
Once a client has signaled that they have a suicide risk, an Aging Life Care Professional will ensure that the older adults receives appropriate services and support needed to effectively meet their immediate and long term needs.
These critical steps may include:
Assess and establish trust with the individual.
Provide counseling and opportunities to express their feelings, concerns, and needs.
Coordinate and ensure that the client receives individualized care and ongoing support for mental and physical health challenges.
Work with the client’s medical providers to ensure the client’s emotional health, mood, and pain is adequately managed
Identify and address substance abuse problems (including OTC, and prescription drugs).
Encourage and coordinate opportunities for social support and connectedness to prevent social isolation and loneliness.
Help the client engage in meaningful activities base don expressed wishes to maximize the client’s quality of life.
Ensure the client has adequate support and assistance to address identified functional and cognitive changes
Help the client strengthen their ability to cope with and adapt to change; provide them with opportunities to have purpose and control over realistic areas.
Focus on what they do well and encourage growth along this path.
Provide emotional support to the client and the family system.
Refer the client to appropriate medical and therapeutic services (i.e., psychiatry, psychotherapy, support groups, memory cafes, etc.)
Reach out via our contacts tab if you need assistance in this area! We are here to help assess, support, and intervene. Utilizing an Aging Life Care Professional who has extensive mental health experience to assess for cognitive impairment and depression and to find creative ways to resolve dysfunctional patterns is critical to successful outcomes.
If you believe that your older loved one’s risk is urgent, or you are feeling suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-8255. They are available 24 hours a day.
Substance Abuse and Mental Health Services Administration (SAMHSA)
Administration on Aging (AoA)