Risk and protective factors against suicide in older people
Population aging is a global phenomenon. According to data from the National Institute of Statistics (INE), there are 9.39 million people over 64 years old in Spain, and this number is expected to exceed 15 million by 2049.
This period of life brings great changes individual and social experiences that can be lived as adversities or losses:
- Aging.
- The appearance of certain diseases (many of them limiting and painful) and the loss of some bodily functions (cognitive, visual, auditory and sphincter control loss).
- Retirement, which often brings with it a sometimes inevitable feeling of "no longer feeling useful."
- The death of loved ones.
- The loss of social circles, social isolation, and loneliness.
- A new awareness of death.
- The generation gap, which leads to communication difficulties.
Ageing and suicide
There is a myth about suicide in older people that assumes that, since it is the stage of life closest to death, it is "normal" Having thoughts of death or suicide. According to data from the Spanish National Statistics Institute (INE), in 2020, 1,256 people over the age of 64 died by suicide in Spain, and the suicide rate per 100,000 inhabitants increases considerably in people over 80. Suicide attempts are often serious in older adults, and the vast majority die on their first attempt. This data gives us a perspective on the severity of suicidal behavior in this population.
One of the crucial aspects of suicide prevention is being able to identify people who have suicidal thoughts and understanding that it can affect anyone.
Suicidal behavior (suicidal thoughts and attempts), in the vast majority of cases, is triggered by an adverse life situation in which the person sees death as a liberation and the only way out, believing they cannot change their circumstances. The desire to die is greater than the desire to live.
Risk factors for suicide in older adults
- Depression is one of the most significant risk factors. Some studies indicate that most people who die by suicide had symptoms of depression. And other studies estimate that up to 18% of the elderly population experiences depression (Baladon et al., 2015). Symptoms vary at this stage of life, and often there is no outward expression of sadness, but they commonly present with restlessness, loss of appetite, sleep problems, and so on.
- Alcohol abuse.
- Feelings of guilt, hopelessness, low self-esteem, and helplessness. Feeling like a burden to their family.
- Rigidity, lack of cognitive flexibility, and perfectionism.
- The presence of a serious and chronic illness, especially those involving pain, disability, changes in social interaction or participation, and associated psychological suffering, is a significant risk factor. It's important to note that some neuropsychiatric illnesses can cause impulsivity, aggression, and hostility, which in turn increase the risk of suicidal behavior.
- History of previous suicide attempts.
- To be a man.
- Socioeconomic precarity.
- Living alone: separation, divorce, widowhood, or having little social or family support. Widowhood poses a particular risk in the first two years after the death of a spouse.
- Loneliness: feeling disconnected from one's social and family circle or friends.
- The loss of one's home, especially when entering nursing homes.
- Suffering abuse or neglect.
- A large percentage of caregivers are older people and may be at greater risk of suicide when there are feelings of helplessness, hopelessness and exhaustion from caregiving.
Protective factors against suicide in older adults
One of the interventions in preventing and reducing the risk of suicidal behavior is to promote or strengthen protective factors . Some of these are:
- Having children and family support with whom the person feels supported, recognized and respected.
- Having a social network that makes you feel integrated and with a sense of belonging.
- Having access to social resources that allow them to have housing, transportation, food, and healthcare.
- Having social skills that allow him to integrate into the changes that come with aging and developing interests that give him a daily routine.
- Having self-confidence, self-control, adaptability, knowing how to ask for help in adverse times, and the ability to express unpleasant feelings.
- To follow healthy lifestyle habits, have physical health and a perception of quality of life.
- Having medical follow-up from healthcare services is essential. Telehealth services can be a very useful tool.
- To feel that life has a purpose.
- Being a religious person.
Suicide is possible and should be done Prevention. One of the crucial aspects of suicide prevention is being able to identify people who are having suicidal thoughts and understanding that it can affect anyone. When we detect this situation, it is essential not to ignore it and to ensure that the person receives help. We must offer our support, showing understanding and active listening, and having patience and an empathetic attitude.
A Public Health Problem
Special attention should be paid to situations such as:
- The expression of suicidal thoughts.
- Accidental ingestion of medications and medication accumulation.
- Finding farewell notes, or recent changes to insurance or wills, or the delivery of important personal items.
- Loss of interest or abandonment of activities.
- Neglecting self-care and medical check-ups, and refusing care from third parties.
It is important to prevent the person from harming themselves, and we must ensure they do not have access to substances or objects that could be used to attempt suicide: medications, chemicals, sharp objects, etc. It is crucial that people with suicidal thoughts are not alone and do not feel alone, and we must ensure they receive care from healthcare services. We can go to their primary care physician or the emergency room of the nearest hospital.
If you are having suicidal thoughts, contact us
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