Suicide Notes From Older Adults Suicide Notes example essay topic

Depression and suicide are two causes of death that are increasing in prevalence for all age groups. They are also on the rise in a specific age group, that of older adults. The theory behind this finding that older adults are becoming more and more depressed and committing suicide at a greater rate than ever before is due to their failing physical and mental health. The purpose of this paper is to expand upon and prove this theory by gathering statistics about suicide in older adults, and by obtaining the information of scholarly sources by summarizing their views as it relates to the above mentioned theory. Official suicide statistics identify older adults as a high-risk group (Mireault & Deman, 1996).

In 1992, it was reported that older adults comprised about 13% of the U.S. population, yet accounted for 20% of its suicides; in contrast, young people, ages 15-24, comprised about 14% of the population and accounted for 15% of the suicides (Miller, Segal, & Coolidge, 2001). Among older persons, there are between two to four suicide attempts for every completed attempt (Miller, Segal, & Coolidge, 2001). However, the suicide completion rate of older adults is 50% higher than the population as a whole. This is because older adults who attempt suicide die from the attempt more often than any other age group. Not only do elders kill themselves at a greater rate than any other group in society, but they tend to be more determined and purposeful (Weaver & Koenig, 2001). Studies of Depression and Suicide in Older Adults Depression in Older AdultsA study was conducted examining the relationships between disease severity, functional impairment, and depression among a sample of older adults with age-related macular degeneration.

It showed that the relationship between visual acuity and physical function was moderated by depressive symptoms (Casten, Rovner, & Edmonds, 2002). It appears that when faced with vision loss, depressed persons tend to generalize their disability to activities that are not necessarily vision dependent. They seem to adopt the attitude of not being able to see leads to not being able to do. This attitude is in line with the cognitive theory of depression in which depressed persons engage in faulty information processing (Casten, Rovner, & Edmonds, 2002).

Suicide in Older AdultsA study about older adult suicide was conducted by Zweig and Hinrichsen (1993). This study included 150 community-dwelling adults, age 60 and over, who were admitted to a psychiatric inpatient service. Each member met the criteria for major depressive disorder. The patients and family members were interviewed six and twelve months after the patients were admitted to the hospital. Eleven of the 126 older patients attempted suicide within the year following inpatient admission for major depressive disorder, however none of the attempts resulted in death (Zweig & Hinrichsen, 1993). Of the patients who attempted suicide, 73% did so during the six to twelve month period following hospitalization (Zweig & Hinrichsen, 1993).

The study then went on to explore the differences between those who attempted suicide and those who did not. Individuals who attempted suicide occupied, on average, a higher social class position (Zweig & Hinrichsen, 1993). They were also less likely to experience remission, and were more likely to relapse if they did experience remission. The study also found that interpersonal factors were associated with suicidal behavior in the patients.

Suicide Notes From Older Adults Suicide notes are traditionally considered markers of the severity of the suicide attempt and often provide valuable insights into the thinking of suicide victims before the final act (Salib, Cawley, & Healy, 2002). A study was done examining the phenomenon of suicide notes in 125 older people who died unexpectedly and in whom a suicide verdict was returned by the Coroner over a period of 10 years. The goal of the study was to see whether there was a difference between suicide note-leavers and non-note-leavers in older victims of suicide (Salib, Cawley, & Healy, 2002). Data was collected from the files of a Coroner's office in a particular town. All of the data was from deceased people aged 60 and above whose deaths were ruled as suicides. Deceased older adults who left suicide notes were compared to those who did not over a period of ten years.

During the 10-year review period, 125 older people died as a result of suicide. In 54 cases (43%), a suicide note was found in the coroner's records for 31 (57%) males and 23 (47%) females (Salib, Cawley, & Healy, 2002). For note-leavers, the average age was 71, and for those who did not leave notes, the average age was 74. Older suicide note-leavers were less likely to be known to psychiatric services, did not have recent psychiatric treatment, and were less likely to have used violent methods, and did not previously attempt suicide. Suicide notes accompanied most of the cases of suicide that resulted from an overdose, using plastic bags, electrocution, or using car exhausts. Most cases of drowning did not leave suicide notes, none of the men who killed themselves by drowning or falling from a height left suicide notes, nor did the deceased who fatally wounded themselves or jumped in front of a train.

More women than men who chose to die by hanging left notes (Salib, Cawley, & Healy, 2002). Those who died by hanging, jumping from heights, immolation, or wounding appeared equally likely to leave or not leave a note (Salib, Cawley, & Healy, 2002). Also, older people who killed themselves at weekends were less likely to leave a suicide note. older people who were in their 70's referred primarily to financial problems, social isolation, fear, sadness, loneliness, and physical illness (Salib, Cawley, & Healy, 2002). This study found that many older people may be isolated and have no one to communicate with, while others may no longer have the ability to express themselves.

Failure to identify consistent parameters that could differentiate between note-leavers and non-note-leavers should not be taken to mean that absence of a suicide note must not be considered an indicator of a less serious attempt (Salib, Cawley, & Healy, 2002). Reasons for Depression and Suicide in Older Adults Depression in Older Adults Depression is the most common diagnosis in older adults who have attempted suicide (Zweig & Hinrichsen, 1993). Depression frequently accompanies a chronic disease, particularly when the disease impairs function (Casten, Rovner, & Edmonds, 2002). Physical health status is the most consistently reported risk factor for the onset and persistence of depression in late life (Gatz & Fiske, 2003). Several other common correlates have been associated with older adult depression, such as cognitive dysfunction, genetic factors, interpersonal relations, and stressful life events. Depression can also be brought on by anxiety in older adults.

In fact, the relationship between anxiety and depressive symptoms in later life are relatively common among older adults (Wether ell, Gatz, & Pederson, 2001). However, little is known about the particular features that may distinguish elders with anxious depression from elders with depression alone (Lynch, Compton, Mendelson, Robins, & Krishnan, 2000). Suicide in Older Adults Physical illness is a common antecedent to suicide in older people, though prevalence figures vary widely from 34% to 94%; however the risk of suicide associated with physical illness is unclear because there are few controlled studies (Waern et al., 2002). Other factors that have been associated with late-life behavior are chronic severe pain, debilitating disease, and diagnosis of a terminal illness (Mireault & Deman, 1996). Also, of older adult suicides who have been studied through a psychological autopsy method, it is most often the case that a psychiatric illness, in particular depression, was present prior to death (Pearson, Conwell, Lindsay, Takahashi, & Caine, 1997). Another reason that older people commit suicide is due to unbearable psychological pain, which produces a heightened state of perturbation.

The person wants primarily to flee from pain, such as feeling boxed in, rejected, and especially hopeless and helpless (Leenaars, 2003). The suicide is functional because it provides relief from the intolerable suffering. Also, a history of suicide attempts and the level of intent associated with suicidal acts have been demonstrated to be correlates of subsequent completed suicide (Connor, Conwell, & Duberstein, 2001). Inability to adjust is yet another reason for older adult suicide. This includes several disorders such as depressive disorders, anxiety disorders, schizophrenic disorders, brain-dysfunction disorders, and substance-related disorders.

Another reasoning of older adult suicide, rejection-aggression, was first documented by Steel in the famous 1910 meeting of the Psychoanalytic Society in Freud's home in Vienna (Leenaars, 2003). The idea behind this reason is that often times a rejection leads to pain and self-directed aggression. Alcohol use also appears to be a major precipitating factor in geriatric suicide. Older adults who abuse alcohol are more likely to attempt suicide compared to those who consume little or no alcohol (Mireault & Deman, 1996).

Identification-aggression, an idea hypothesized by Freud, is another factor in older adult suicide. With this idea, Freud believed that intense identification (attachment) with a lost or rejecting person is crucial in understanding the suicidal person. If this emotional attachment is not met, the suicidal person experiences a deep pain (discomfort) and wants to egress or escape (Leenaars, 2003). Interpersonal relations are often a factor in older adult suicide. If older adults have trouble establishing or maintaining relationships, they develop a disturbed, unbearable interpersonal calamity.

Cognitive constriction is also a factor in older adult suicide. The common cognitive state in suicide is mental constriction, such as rigidity in thinking, narrowing of focus, tunnel vision, and concreteness (Leenaars, 2003). The person experiences combinations of a trauma such as poor health or rejection from a family member, moments before his or her death. It has also been found, in one population based case-control study, that visual impairment, neurological disorders, and malignant disease were associated with suicide in older people, along with cardiovascular disease, and musculo skeletal disorders (Waern et al., 2002).

Indirect expressions are a reason for suicide among older adults. The suicidal person is ambivalent; they experience complications, contradictory feelings, attitudes and / or thrusts, often toward a person and even toward life (Leenaars 2003). However, the conscience of a person is only a fragment of the suicidal mind (Leenaars 2003). Summary and Conclusions The theory to be corroborated in this paper was that older adults are becoming more and more depressed and committing suicide at a greater rate than ever before, due to failing physical and mental health.

The paper discussed several aspects of this theory including statistics of suicide in older adults, reasons for depression in older adults, reasons for suicide in older adults, and included studies on depression and suicide in older adults. A review of suicide notes from older adults was also conducted. It was found that the theory to be corroborated was successful. It is true, based on the findings from the above mentioned sources, that depression and suicide are increasing in prevalence among older adults due to their failing physical and mental health. There are several aspects to physical and mental health, however they appear to be the main causes for the increase in depression and suicide among older adults.

Reasons for depression among older adults briefly include anxiety, cognitive dysfunction, genetic factors, interpersonal relations, and stressful life events. Reasons for suicide among older adults can be briefly summarized by physical and psychiatric illnesses, unbearable psychological pain, cognitive construction, indirect expressions, inability to adjust, interpersonal relations, rejection-aggression, alcohol abuse, identification-egression, visual impairment, neurological disorders, malignant disease cardiovascular disease, and musculo skeletal disorders.