When it comes to suicide prevention, seniors are often overlooked. But Katherine Suberlak, a social worker and vice president of clinical services at Oak Street Health, a network of primary care centers for adults on Medicare, wants to ensure care for older adults is part of the conversation.
“In the last couple of years, we’ve seen an increase of isolation and loneliness—both coming from a place of safety as it relates to the COVID-19 response,” says Suberlak. “But we also need to adjust to this new normal and make sure our seniors are well supported in their community and that both their primary care and mental health needs are met. It’s about caring for the whole person.”
Although adults 65 and older comprise 12% of the population, they account for 18% of suicides. Some of the risk factors include loneliness, which is often attributed to loss of a spouse or partner and living far from family and friends. Added to that is the reality that seniors are less likely to seek help for mental health issues, with less than 5% of people 65 and over having received counseling or therapy in the last few years.
“One of the strongest risk factors [of suicide] is if there’s a concurring psychiatric disorder at the time of death,” she says. “So if someone has experienced chronic mental illness and has not received treatment, that would be a large risk factor.”
Although cultural and generational stigmas surrounding mental health are partially to blame, Suberlak notes that access and affordability are also major barriers.
“We didn’t have parity in mental health and medical care until about the last decade,” she says. “So for older adults, their entire experience may have been that they don’t have equitable access or financial access to the care that would relieve their suffering.”
Warning signs to watch for
In older adults, Suberlak says it’s essential to look for engagement, both in their health care and social lives. If you notice a parent or loved one skipping medications or frequently missing doctor appointments, it may be helpful to inquire. Other warning signs include substance abuse and stockpiling medication.
“Skipping an appointment here or there doesn’t mean there’s necessarily huge risk [of suicide], but it’s a warning sign to say, ‘what’s going on here? Why are we detaching from care?’” she explains. “And if you see them cutting back on their social engagement, look for ways to authentically reintroduce that, such as grooming or self-care.”
Talking to your loved one about which part of their identity they felt the strongest tie to in the past and finding ways to reincorporate those aspects could also go a long way in boosting their mood, whether it’s their spiritual or church community or spending time with friends and family members.
“Those community pieces can help people feel tethered because we know when someone’s untethered, they’re at a greater risk for possibly feeling like they could make a decision and have that loss of self,” notes Suberlak. “If community inclusion is something that’s helpful to them, how can we make sure that’s part of their long-term wellness plan?”
A sudden urge to put their affairs in order or giving away items are other signs to consider. While putting together a will as part of preparing for the end of life is normal, it’s important to note whether the interest is coming from a place of hopelessness or a desire to be in control of their estate.
How to support a loved one
If you notice any of the warning signs, take that as an opportunity to start a conversation and enlist the help of a trusted medical professional, such as your parent’s primary care physician. They can help determine whether treatment, like medication or therapy, would be helpful. There’s also the new 988 mental health crisis hotline, which is anonymous and available to those experiencing crisis, as well as people looking to support them. Whatever you do, pay careful attention not to sweep any concerns under the rug.
“Something that’s common among older adults is they don’t want to be seen as a burden to their loved ones,” says Suberlak. “It’s a natural inclination, but it could be unnecessarily harmful.”
Essentially if you notice anything that’s out of the norm for the older adult in your life, don’t hesitate to speak up, ask questions and check in with your loved one regularly.
If you or someone you know is contemplating suicide, call or text the 988 Suicide and Crisis Line or visit 988lifeline.org.