Don’t ignore the senior death wish

JOAN RANKIN TALKS ABOUT HER urge to kill herself in the same tone she describes her daily exercise routine.

“I thought about suicide a couple of years ago,” the 75-year-old says. “I thought I’d walk in front of a train, or something. But I never seriously considered it, and now I can’t remember why I thought about it at all.”

Rankin forgets many things these days -- how long ago her brother killed himself, for instance. But she recalls how her brother’s wife later admitted that it was no accident. Her former husband had been depressed.

Rankin’s suicidal thoughts are common among the elderly. Every 95 minutes, someone 65 or older commits suicide in the United States, according to the American Assn. of Suicidology. The weapon of choice is usually a gun. The most common profile is an 84-year-old white man (senior men are four times more likely to kill themselves than older women). Contrary to stereotype, the majority are not terminally ill and saw their doctors within the previous month.

What’s especially frustrating about elderly suicide is that its causes are easily treatable, requiring little more than paying better attention to older people’s medical care. But this underreported health story -- about 5,500 older people kill themselves each year -- carries a big risk if we continue to ignore it. Researchers studying the implications of the biggest generation in U.S. history to retire (an estimated 77 million by 2030) expect elderly suicide to increase dramatically.

Part of the problem is that the people receiving invitations to join AARP are of the generation that obsessively worshiped youth. Patrick Arbore, director of San Francisco’s Center for Elderly Suicide Prevention and Grief Related Services, worries about baby boomers bridling at the very mention of the word “aging”: “They’re a quick-fix group who will be demanding and impatient. They will bring with them their addictions to cosmetic surgery and perhaps a sense of isolation from multiple marriages.”

It’s a myth that depression is a normal part of aging, says Dr. Yeates Conwell, a leading researcher in elderly suicide who co-directs the Center for Study and Prevention of Suicide at the University of Rochester School of Medicine in New York. He reports that 75% of people who kill themselves after age 65 have treatable mood disorders. Elderly suicide is an important health problem because success follows relatively few attempts, Conwell says. Researchers report anecdotally that young people may attempt suicide more than 100 times before committing it, while the attempt-to-death ratio is closer to 4 to 1 for the elderly.

It need not get that far. “Research shows that if we provide older people with the proper medical treatment, the impulse to die disappears” says Dr. Herbert Hendin, medical director of the American Foundation for Suicide Prevention.

Seniors don’t call suicide-prevention hotlines used by younger people. That’s why Arbore founded, in 1973, the nation’s only 24-hour “Friendship Line” for suicidal elders in San Francisco. Almost 20% of the city’s population is older than 60, and there are more of them living alone in the city than anywhere else in California.

The hotline -- (800) 971-0016 -- logs about 1,400 calls a month, some from as far as North Carolina. But most are from Californians. Most callers avoid the word “suicide.”

Many baby boomers are no better at asking personal, sensitive questions of their parents than their parents were of their parents. They should learn how to ask if their loved one is depressed. And if they can do that -- and they must -- the next step is to come out and say it: “Are you contemplating suicide?”