High U.S. rate of senior suicide gaining notice

Researchers blame depression, social isolation, access to guns

July 21, 2002|By Mary Jo Layton | Mary Jo Layton,KNIGHT RIDDER/TRIBUNE

HACKENSACK, N.J. - Concerned that most Americans are unaware of the high rate of suicide among senior citizens, researchers have issued an alert to the elderly, their families, caregivers and physicians.

Leading scientists have taken a closer look at the reasons people 65 and older commit suicide at a higher rate than any other age group.

Although older Americans make up about 13 percent of the population, they account for nearly 20 percent of all suicides.

The new research confirms what scientists have long identified as contributing factors to elderly suicide: depression, mental impairments, better access to firearms, and social isolation.

One study completed at the University of Iowa College of Medicine found that in addition to depression, lack of social interactions and poor sleep appear to be indications that a senior may take his own life.

Research done at the University of Rochester Medical Center found that suicide rates for elderly people declined significantly in states that required waiting periods and background checks before guns could be purchased.

The studies, experts say, all point to a critical task: ensuring that at-risk seniors are treated for underlying mental and physical problems to prevent suicide.

"I don't think people recognize the severity of this problem," said Dr. Asghar Hossain, chief of psychiatry for geriatrics at Bergen Regional Medical Center in Paramus, N.J. "We have treated and seen many elderly people who have attempted suicide," he said.

Undiagnosed problems

In many cases, seniors have struggled with depression, an illness that has gone undiagnosed and untreated, Hossain said.

An estimated 5 million of 32 million people 65 and older suffer from depression, but many consider it a natural part of aging and, therefore, untreatable. Alcoholism can compound the depression, he said.

Seniors as a group are much more determined to act and use more lethal methods, said Dr. Yeates Conwell, professor of psychiatry at the University of Rochester Medical Center. His research on seniors taking their own lives with firearms is among the studies featured in a recent issue of the American Journal of Geriatric Psychiatry.

Consider this: There is one suicide for every four attempts made by a senior. Yet, in the overall population, there are 20 attempts for every suicide completed.

Problem to increase

"There's a great underappreciation of this problem for a lot of reasons," Conwell said.

Ordinarily, people suspect that teen-agers are more at risk as a group than seniors, Conwell said.

"Somehow our awareness of suicide in later life slips through the cracks. It's a character of our culture. Older people tend to fade into the background."

Conwell also said the problem of suicide among senior citizens will grow as the number of elderly increases in the United States.

"In coming decades, as increasing numbers of people age into the stage of life that carries the greatest risk for suicide, the absolute number of seniors that take their own lives will expand dramatically," Conwell and Jane Pearson of the National Institute of Mental Health wrote in an editorial accompanying the research.

The research comes as no surprise to Denise Arlook, who supervises the care of many seniors in northern New Jersey. She screens clients for depression and often finds many in need of treatment.

"Almost all of my clients are taking antidepressants," said Arlook, a geriatric care manager based in Wayne, N.J.

Arlook recalled a harrowing episode a few years ago in which a Bergen County man threatened to kill himself.

`He had a plan'

"He had a plan and he was ready to act," she said. Isolated, he suffered from depression that went untreated.

Arlook said she contacted a crisis response team from Bergen Regional Medical Center. Ultimately, the man was admitted and underwent treatment for three weeks.

In other cases, help arrives too late. Lt. Frank Manapera, a police officer in Manchester, N.J., an Ocean County hub of retirement communities, has investigated a handful of senior suicides.

Two years ago, Manapera responded to a call from a hysterical housekeeper who heard gunshots and barricaded herself in a room.

Manapera pulled into the snow-covered driveway, entered the house with pistol drawn, and kicked the bedroom door open. He found 87-year-old William Vernon Riemer dead on the floor, he said, with a self-inflicted gunshot wound to the head.

Before he killed himself, Manapera said, Riemer shot his wife, who was bedridden with rheumatoid arthritis.

Riemer himself suffered from intense pain from arthritis, the officer said.

"It's heart-wrenching," he said.

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