Not long after 72-year-old Anne Beale Golsan had retired on
disability from her job as a librarian, she put a stack
of paid bills
out for the mail, hung up a freshly pressed outfit and taped a note to
the front of the house. "Don''t come in by yourself. Get somebody to
come with you. Sorry, Love Beale."Her
niece arrived at the house they shared in Baton Rouge, La., to find
police already there. Golsan had killed herself with a gunshot to the
head.
"Every single day it makes me feel like I wish I could have done
something," Jane Golsan Ray said, recalling her aunt''s death eight
years ago. "I wish I could turn back the clock and prevent it. It
doesn''t get any better, it hurts every day."
The elderly are the highest risk population in the country for
suicide. But few suicide-
prevention programs target them — a result,
advocates say, of scarce funding and lack of concern for older
Americans.
And mental heath experts say the number of elderly suicides is likely to climb as baby boomers enter their twilight years.
The overall U.S. suicide rate is 11 per 100,000 people. But for
those 65 and older, that figure rises to 14 per 100,000, according to
the Centers for Disease Control and Prevention, which based its
findings on 2004 data, the most recent available.
Older adults are less likely to seek help and are more lethal in
their suicide attempts. So experts say special care is needed to reach
out.
Dale Smith, 67, said he might not be alive if not for a suicide-prevention program in Spokane, Wash.
Two years ago, he attended a meeting at his retirement complex where
everyone filled out a screening form for
depression, a key risk factor
for suicide.
Based on his answers, a caseworker and psychiatrist later visited
Smith at his home, where they discussed what turned out to be a
lifetime of depression. They developed a plan of medication and therapy
that Smith says probably saved his life.
"I''m not unique. I think there''s a lot of individuals out there who
do suffer from depression and they have no clue," he said. "They just
know they''re not happy. They are tired, they want to pull the covers
over their heads and not look at the world, and they don''t know what it
is."
But many older Americans have fewer options for treatment than younger people.
"It''s a not-so-subtle social-political assignment of resources,"
said Donna Cohen, a professor in the Department of Aging and Mental
Health at the University of South Florida.
Ten states passed laws last year intended to curb suicide among children and young adults. But only two — New Jersey and New Mexico
— passed laws addressing suicide among the elderly, according to
Suicide Prevention Action Network USA, a national advocacy group based
in Washington, D.C.
Depression is underdetected at all ages, mental health groups say.
But much more funding is available for treating younger people,
including $82 million in federal money approved in 2004.
The situation prompted Sen. Harry Reid of Nevada,
who lost his father to suicide, to propose funding more
suicide-prevention programs for the elderly and changing a Medicare
coverage rule that forces seniors to pay more for outpatient mental
health services than other medical care.
Some advocates and mental health workers say they also have to
battle a prevailing notion that depression is a normal part of aging.
"It is not natural and should be treated at all times," said Dr.
Paula Clayton, a psychiatrist and medical director for the American
Foundation for Suicide Prevention.
Janice Hodge of Sandy, Ore. said she didn''t realize until after
her 91-year old father, Anthony Liberto, died that he had been
depressed.
He was struggling to care for his 85-year-old wife, who
suffered from Parkinson''s disease. He did not work and he could no
longer play golf, his favorite pastime. Friends and family still
visited, but they say he spent much of his time lying on the couch and
with suggestions that he place his wife of 62 years
in a nursing home.
Eventually, he shot his wife and killed himself, leaving a note
that read: "Sorry we had to leave this way, forgive me. Love, your
Dad."
Experts say there need to be services tailored to the elderly because they handle depression differently than younger patients.
In Spokane,
the program that helped Smith, called Elder Services, trains people who
come in contact with the elderly — from bank tellers to postal carriers
— to notice signs of trouble, such as mail piling up or bills going
unpaid. Those people can then notify social workers.
In San Francisco,
Patrick Arbore founded the Friendship Line in San Francisco in 1973
after seeing the lack of understanding some suicide hot line workers
displayed for older people.
The line, which lets people call just to talk or get support,
now handles more than 3,000 calls a month. About one-quarter of the
callers have suicidal thoughts, a staffer said. But most just want a
compassionate listener.
"It''s about reminding people that they are still a part of their community," Arbore said. "Those connections bind us to life."