Senior Depression: Early Warning Signs
David was born and raised on a ranch. He was married on a ranch, raised his kids on a ranch, and grew his herd from just a few head of cattle when he and his wife were married, to over 600 head on property that expanded to over 1,000 acres. He loved ranching! He went our every morning before dawn to supervise the ranch hands as they fed the herd. As he put on his cowboy hat each morning before stepping outside, he said that brought him to life and put him in the ranching "zone" that energized him. Even later after his first stroke, his number one cowboy would pick him up and drive him around the property in his customized pickup truck every morning. That is what he lived for, the thing that gave purpose and meaning to his life, and he loved it.
But then he had another stroke, and a serious fall that put him in a nursing home for about six weeks. When he finally was ready to be released back home, something had seriously changed. He didn't want to go out to see the ranch anymore. Laying in bed was all he wanted to do. Even going out to take a dip in the hot tub, which he used to enjoy almost daily, no longer appealed to him. Now the family is worried because the last time his son suggested a dip in the hot tub he replied: "sure, just tie a rope around my neck and throw me in."
The suicide rate in seniors is 20% higher than the general population, and according to a recent article in The New York Times, that rate my be significantly under reported by coroners because of the stigma created for the remaining family members. Guns in the home are a serious concern, as this is most often the chosen path for elderly people choosing to end their lives (72% of all suicides in people over 65 are committed with a firearm) . In addition, since we know that 60% of people who attempt suicide do not plan it, and that this statistic is compounded by the rate of Alzheimer's and dementia in people over 65, the urgency of keeping firearms out of reach and at least under lock and key becomes extremely important for our aging population.
What to Look For
According to the Veteran's Administration addressing concerns with Senior Home Care, these are the warning signs to look for:
A. Verbal DIRECT: “I am going to kill myself.” INDIRECT: “You are all going to be sorry, when I am no longer here.” “My life is not worth living anymore.”
B. Psychological • long term depression • feeling helpless • feeling hopeless • feeling overwhelmed • feeling sad
C. Emotional • pre-occupation with death • lack of appetite/overeating • sleep disturbances • poor concentration • isolation • crying
D. Behavioral • low self esteem • inability to perform daily tasks • previous suicide attempts • suicide note • engaging in risky or impulsive behavior • sudden poor school or job performance • giving away important things • lack of interest in things previously enjoyed • sudden refraining from activities with family and friends • sudden unexplained recovery from depression, sudden positive outlook
E. Situational • school or career problems • loss of job/career • death of a loved one or peer • suicide of a loved one or peer • relationship break-up/separation/divorce • multiple losses • terminal illness
Things you should ask and do:
• Are you thinking of hurting yourself (committing suicide)?
• How long have you been thinking about suicide (frequency, intensity, duration)?
• Do you have a plan? Get specific information if there is a plan.
• Do you have the means to carry out the plan (accessibility of a weapon, pills, drugs, etc.)?
• Have you attempted suicide in the past? • Has someone in your family committed suicide?
• Is there anything or anyone to stop you (religious beliefs, children left behind, pets, etc.)?
• Depending on the responses: † Set up a suicide contract † Provide the client with emergency/crisis numbers † Explore what resources are available, e.g. family support, friends, etc. † Develop a plan to deal with potential weapons, medications, drugs, etc † Increase frequency of counseling sessions, possible phone check-ins o Assess the need for getting the client assessed for medications o Assess the need to contact the “crisis team” if available at your agency † Get the client hospitalized if necessary
Feel free to download our free mini-assessment for depression if you suspect you mom or dad may be depressed: