Suicide among older adults is frequently triggered by a sense of hopelessness caused by a senior's loss of control over their health or financial circumstances.

By the time older adults reach their seventh decade of life, it is inevitable that their thoughts will turn to life evaluations and conclusions. In what ways have your achievements or accomplishments marked your life's journey up to this point? What opportunities does life have in store for us over the next few decades? Has life lived up to your expectations? Are there any objectives that have yet to be met?

The transition to older adulthood is often marked by thoughts of contentment with the past and confidence in the future—emotionally, financially, and socially—in the events of life that are yet to unfold. In the case of some older adults, however, such feelings of fulfillment and confidence are elusive or non-existent. Some older adults choose to end their lives prematurely because they feel hopeless about the prospects for a fulfilling future in front of them.

According to the American Association of Suicidology, there were 5,404 suicides among people aged 65 and older in the United States in 2005, the most recent year for which statistics were available. Approximately 15 elderly people commit suicide every day, or one every hour and 37 minutes, based on this figure. Despite the fact that older adults made up only 12.4 percent of the population in 2005, they accounted for 16.6 percent of all suicide attempts.

Who is it, and why is it important?

In comparison to older women, older men are at greater risk of committing suicide. White males over the age of 85 who are white are at the greatest risk of developing dementia compared to all other older adults.

According to Patrick Arbore, EdD, director of the Center for Elderly Suicide Prevention and Grief Related Services Institute on Aging in San Francisco, the challenges placed on aging individuals can result in depression, which can quickly progress to clinical depression. "An older person who is diagnosed with a complex illness such as cancer, Parkinson's disease, diabetes, dementia, or another form of dementia may experience depression," says Dr. Adler.

Likewise, losses such as the death of loved ones, the death of pets, and even the potential loss of one's own life can be extremely difficult for elders to cope with, according to him. When it comes to maintaining one's independence, "fears about one's ability to do so can cause enormous anxiety, especially when the older person places a high value on autonomy above all else."

According to John L. McIntosh, PhD, a professor of psychology at Indiana University South Bend, research in gerontology has revealed a pattern in older adulthood associated with greater happiness in later life with activity and flexibility. Conversely, a lack of such attributes or styles may be associated with unhappiness and possibly suicide in later life, according to McIntosh. In late life, McIntosh believes that "health, finances, and social support" are all extremely important issues to consider. "Suicide and depression are almost certainly issues to consider as well," he says. A large number of studies have consistently demonstrated the strong link between suicide and depression.

According to Iris Chi, DSW, Golden Age Association Frances Wu Chair for Chinese Elderly School of Social Work Davis School of Gerontology at the University of Southern California in Los Angeles, depression among older adults is underdiagnosed, a problem that needs to be addressed. In her research, she found that older adults with personality types that are less open and more inward are more likely to commit suicide than their younger counterparts.

In addition to timidity, shyness, and seclusiveness, Arbore cites a tendency toward hypochondria, hostility, and a rigid and fiercely independent way of life as other personality traits associated with older adult suicide.

Suicide is also associated with other factors such as frustration and anger, both of which can result in aggressive behavior toward oneself, according to Arbore. Other factors that may be present include physical or psychological pain, unmet psychological needs, and feelings of helplessness or hopelessness, among others.

"Attitudes and beliefs, particularly those related to autonomy, dignity, and responsibility, can play a significant role in suicide," explains Arbore. According to the National Institute on Aging, "Alcoholism and other substance use disorders place older people at significantly increased risk for suicide."

According to McIntosh, suicide among older adults is "the result of a variety of factors acting in concert." A single factor would only rarely, if ever, be the cause of a suicide." Problems in the medical, psychological, or social realms, as well as a combination of difficulties in several areas, can contribute to suicidal ideation in older adults, according to the American Psychological Association.

Chi explains that, in contrast to suicides among young people, "elder adult suicide is not an impulsive act." "Elderly suicide has been on the minds of many people for a long time."

Although it may appear as if suicide is an impulsive act, according to Arbore, people may have been thinking about it for many years before taking the step of actually doing it.

The majority of older adults who have dealt with stressors and problems throughout their lives have developed effective coping mechanisms and responses that have enabled them to deal with distressing or burdensome situations in their lives. According to McIntosh, elders who are at increased risk for suicide adopt a psychological perspective that includes an inability to tolerate the level of psychological pain they are experiencing, a belief that there are no solutions to their problems, a belief that they are powerless to change their life circumstances, a belief that they are a burden to others, and a belief that life has no meaning.

Identifying the Early Warning Signs

Arbore advises that family members and professionals should be on the lookout for any changes in behavior among older adults. According to him, "in our ageist culture, many family members believe that depression is a normal part of growing older." He goes on to say that people with sleep problems, whether they are sleeping too much or too little, eating problems, or other signs of depression should be taken seriously.

Of course, the presence of firearms in the home increases the likelihood of a crime occurring. McIntosh says that when people make verbal statements about wanting to die or kill themselves, they should be taken seriously and mental health assistance should be sought immediately.

"There are few resources designed specifically for older adults who are suicidal," he laments, but he points out that "every community will have mental health professionals as well as hotlines or even suicide prevention centers available to which they can turn for help for the older adult," he adds. He recommends that older adults call a national hotline number, 800-273-TALK (8255), which is available 24 hours a day.

Arbore also points out that the Center for Elderly Suicide Prevention and Grief Related Services is the only national hotline for older adults that is available 24 hours a day, according to Arbore. Established in 1973, the "Friendship Line for the Elderly" has been providing 24-hour assistance to older adults who are depressed, isolated or bereaved, lonely or at risk of suicide since then.

Taking a Look Ahead

According to the experts, addressing the issue of older adult suicide in the United States will be difficult due to a number of significant obstacles. 'In our ageist, death-denying culture, many older people, particularly men, are prone to feelings of hopelessness and suicidal ideation because they believe that old age is a descent into loss and suffering,' says Arbore. "

According to him, "because men have been socialized since childhood not to express their feelings, they have no way of expressing their fears about the inevitability of death." He also believes men are frightened by the concept of life's transience, which he believes is terrifying. As an example, he suggests that committing suicide can help you express your fear by allowing you to take control of your experience. In his words, "the inability to accept life on life's terms is the driving force behind suicidal ideation." "Unfortunately, I believe that we as a society have a long way to go when it comes to reducing the risk of suicide among older people."

The large cohort of baby boomers who are approaching older adulthood has prompted speculation about their potential impact on the nation's suicide rates. "As the large number of baby boomers reach old age in the upcoming years, there is some expectation that the rate of suicide among the elderly will rise," says McIntosh. "However, this increase is anything but certain to occur," he asserts. While such an increase is theoretically possible, he argues that baby boomers are better educated, are expected to have more financial resources associated with that education and higher pay over their lifetime, and are in better health than most previous generations.

Chi emphasizes the importance of improving healthcare and mental health services for older adults, as well as raising public awareness of these issues through public education. Among the organizations that have developed programs for healthcare clinics to improve recognition and treatment of depression and suicidal symptoms in older adults is the National Institute of Mental Health (NIMH).