This paper is an examination of the issue of suicide among the elderly in America. Between 1940 and 1980, suicide rates among those 65 and older had been declining. However, in 1980, the rate began to increase; while individuals over 65 now constitute 13 percent of the total population, they account for 20 percent of all deaths attributed to suicide. This is not solely an American problem: older males have the highest rate of suicide in almost every industrialized nation in the world. Depression is the most common single diagnosis leading the suicide, and the increased social acceptability of suicide may be one the most important factors in a depressed individual's choice to end his or her life. Since most older people do not seek outside help for their depression and suicidal thoughts, physicians, social workers, and family members need to learn to recognize this growing problem and institute preventive measures where possible.
James R. McCartney, director of geriatric psychiatry at Lifespan Academic Medical Hospitals in Providence, RI, argues, "Suicide or attempted suicide . . . is always an act against the self and a communication to others for whom the termination of one's life has some real or hoped-for meaning" (Conwell, et al., 1988, Spring, p. 123). The decision to end one's life can be a cry for help or attention, an expression of deep anger, or a confused response to feelings of helplessness and hopelessness. It can be triggered by mental illness, significant life events, or a moment's impulse. While psychologists and social workers have studied suicide in some depth, the increasing problem of suicide among the elderly has received professional attention only recently.
For 40 years, from 1940 to 1980, suicide rates among those 65 and older had been slowly declining in the United States (JAMA, 1996, February, p. 509). Between 1980 and 1990, however, the rate began to increase slowly, and, by 1992, the last...