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Suicide Prevention For Geriatrics

WHAT YOU NEED TO KNOW:

It is common for an elderly person to talk about death and dying, especially if he has a worsening medical condition. This makes it difficult to recognize when an elderly person is planning suicide instead of just thinking or talking about it. Learn to recognize warning signs that the person may be considering suicide. Locate resources to help prevent the person from attempting to take his life.

DISCHARGE INSTRUCTIONS:

If the person is having thoughts of suicide:

  • Call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  • Contact the person's therapist. The person's primary healthcare provider can give you a list of therapists if the person does not have one.
  • Keep medicines, weapons, and alcohol out of the person's reach. Do not leave the person alone. Stay with him if he says he wants to commit suicide or you think he may try it. Make sure you do not put yourself at risk if he has a weapon.
  • Do not be afraid to ask if he is thinking of ending his life. Ask if he has a plan for hurting or killing himself. Ask what he would use to kill himself and if he has it.

Watch for warning signs:

  • Changes in how he talks about death: The person may suddenly talk about death or suicide when he never did before. He may talk about death and dying more than usual, or he may suddenly stop talking about it altogether. He may tell you he sees no reason to live or that he is in constant pain. He may say he knows he will die soon, so he should end his life to prevent pain and suffering. He may say his family will have an easier time when they no longer have to care for him.
  • Suicide plans: The person may say he wants to hurt or kill himself. He may try to get items he could use to kill himself, such as a gun or extra prescription medicine.
  • Changes in appearance or routines: The person may gain or lose weight, or he may have less energy than usual. He may have trouble sleeping or spend a lot of time sleeping. He may eat more than usual, or stop eating or drinking. The person may withdraw from others or stop doing things he enjoys.
  • Mood swings: The person may seem hopeless, anxious, or angry and then suddenly become happy or peaceful.
  • Drug or alcohol use: The person may have new or increased drug or alcohol abuse. He may stop taking prescription medicine or take too much. He may secretly collect medicine instead of taking it so he has enough to use for an overdose.

Follow up with the person's primary healthcare provider or therapist as directed:

Write down your questions so you remember to ask them during your visits.

Medicines:

Medicine can help the person feel well enough to continue with all of the treatment he needs.

  • Antidepressants: These help reduce and control symptoms of depression. Rarely, antidepressants can make a person more likely to act on his suicidal thoughts. The person will need to take this medicine as directed. A sudden stop can be harmful, so he must not stop taking the medicine unless directed. It may take 4 to 6 weeks for the medicine to help him feel better.
  • Mood stabilizers: These help prevent mood swings.
  • Antipsychotics: These help decrease symptoms of severe agitation and anger.

Therapy:

  • Life review therapy: This therapy focuses on both the successes and failures of the person's life. He can express his feelings and find peace with anything he feels is not resolved.
  • Cognitive bibliotherapy: This therapy uses written materials or computer programs to help the person change thoughts that make him feel depressed.
  • Problem solving: This kind of therapy helps the person find the best way to solve problems. It may also help reduce his desire to commit suicide when he is faced with hard times.

How to help the person:

  • Drug or alcohol treatment: Encourage him to seek help for drug or alcohol abuse. Drugs and alcohol can make suicidal feelings worse and make the person more likely to act on them.
  • Social connection: Help him connect with others. Encourage him to become involved in his community. Some examples are tutoring a young student, volunteering at a local organization, or joining a group exercise program.
  • New experiences: Encourage him to try new things. Elderly people who are open to new experiences handle stress and change better than those who are not.
  • Offer support: Call, visit, or send postcards to him often. Check on him after the loss of a pet, longtime friend, or child. Holidays, birthdays, and anniversaries can be difficult for a person after a loss. The loss of a spouse can be especially painful and lonely.
  • Adaptive equipment: Help the person get equipment that will increase his comfort and mobility. Examples are hearing aids, glasses, large print books, and walkers. The person may need help setting up a computer or creating an e-mail account to help him remain connected to others.

For support and more information:

  • National Suicide Prevention Lifeline
    NA
    New York , NY 10004
    Phone: 1- 800 - 273-TALK (8255)
    Web Address: http://www.suicidepreventionlifeline.org
  • Suicide Awareness Voices of Education
    8120 Penn Ave. S., Ste. 470
    Bloomington , Minnesota 55431
    Phone: 1- 952 - 946-7998
    Web Address: http://www.save.org

Contact the person's primary healthcare provider or therapist if:

  • The person has intense feelings of sadness, anger, revenge, or despair, or he cannot make decisions easily.
  • The person tells you he has more thoughts of suicide when he is alone.
  • The person withdraws from others.
  • The person stops eating, or begins to smoke or drink heavily.
  • The person feels he is a burden because of a disability or disease.
  • The person has trouble dealing with stress, such as a breakup or a job loss.
  • You have questions or concerns about the person's condition or care.

Return to the emergency department if:

  • The person has done something on purpose to hurt himself or tries to commit suicide.
  • The person tells you he made a plan to commit suicide.
  • The person acts out in anger, is reckless, or is abusing alcohol or drugs.
  • The person has serious thoughts of suicide, even with treatment.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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