I know now older people on average are happier and more contented than the young, according to endless surveys. But back when a dear old friend was in his early 80s and threatening suicide, I believed his was a rational response to his circumstances. His wife of 60 years had died; he’d moved himself into an aged care residence. He was suffering pain, and was full of the weariness of life. Though his misery seemed perfectly understandable we didn’t stand by. He received psychiatric treatment for anxiety and depression, it worked, and amazingly within a year he’d fallen in love. He had reason to live.
Suicide among older men is a serious problem around the world. Many still believe misery and depression are the handmaidens of old-age and do nothing. They haven’t caught up with the happiness research: older people cope surprisingly well. Even so, some older men, in particular, suffer loneliness, depression and despair.
In Australia, 749 men aged 75 and older killed themselves over the five years from 2009-2013, according to the Australian Bureau of Statistics. That’s about four a week. It’s a relatively small number compared to the 1,985 men aged 35-44 who suicided. But it’s the rate for men over 85 that’s staggering: 34.4 per 100,000, a third higher than for men aged 35-44 and much higher than for younger men and all women. The focus is on prevention among younger people and the middle-aged but too little attention has been paid the elderly.
Recently I went to a forum in the NSW Parliament on suicide of elderly men organised by COTA NSW. It became quite heated as some members of the audience insisted some of the suicides were possibly a form of euthanasia for men who took a rational approach to ending their life. They’d lived long enough and in their circumstances, usually of chronic pain or terminal illness, they didn’t see the point of struggling on. It was not an act of hopelessness but of control.
But Dr Rodney McKay, director of psychiatry and mental health programs at the NSW Institute of Psychiatry, like others in the profession, was having none of that. Euthanasia, he said, was a separate issue. The focus on euthanasia led too many to dismiss the role of psychiatric and social problems among the elderly, problems with a solution. “It’s hard to reconcile the grief everyone feels with the idea that suicide of older people is somehow okay,” he said. ”I’ve yet to meet a family member who says after a suicide (of an old person) ‘well that’s a relief.’”
In the UK the rate of suicide among elderly men has been reduced over twenty years and is half Australia’s, he said. No-one is exactly clear what worked. But later in the day I met Janet Morrison who heads the charity Independent Age UK and has been a prime mover in the UK’s Campaign to End Loneliness. She was attending the International Creative Ageing conference.
“Over 40 years the international data shows that about 10 per cent of the older population are always lonely, and that hasn’t changed,” she said. “But with an ageing population that 10 per cent is quite a large number of people.”
People can be lonely at any age, she said, but the dangers for elderly people of bereavement, loss of mobility, of being a carer, or going into aged care threaten to turn a temporary phase into a chronic feeling of hopelessness. About 2,000 organisations have signed up to end loneliness and the UK campaign has helped raise public awareness. Whether it’s helped reduce the suicide rate is unclear.
Does Australia need such a campaign? It would be useful to have proper evidence of the loneliness problem here. If it stacks up, a national campaign with appropriate support services sounds a good idea, providing we don’t make the lonely sound pitiable. Loneliness arises time and again in the few studies on suicide in the elderly: “Loneliness and lack of social support are two conditions that may push the individual to feel hopeless, especially those individuals facing stressful life events,” say the authors of a paper called Suicide in the old elderly.
It’s not hard to imagine how some elderly, widowed men can find themselves in a downward spiral. A lifelong dependence on women for family and social connection can leave a widower bereft. With no-one to talk to, and unable to express his feelings, a man’s sense of isolation can be overwhelming. The Creative Ageing conference made a powerful case for older people to have access to creative pursuits that absorb them so the hours fly by. Just waiting for a weekly visit from a volunteer may not be enough.
Depression also tends to be under-diagnosed. The ageist idea that old age is naturally miserable plays its part here. One study showed fewer people aged 80 and over who died by suicide had received anti-depressant prescriptions during the last months of life than younger people.
Personally I don’t see why the move for assisted dying/euthanasia laws should detract from any need to combat loneliness and depression among the elderly. Both are valid goals.
For help, contact Lifeline on 13 11 14 or MensLine Australia on 1300 78 99 78
What’s your view of loneliness/depression in old age? Please comment.
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