This part of aging can be dangerous
Some signs of aging are easy to spot – a touch of forgetfulness, a slowing gait, a shaky hand.
But old age also has demons that are not so apparent, such as anxiety and depression. In some cases, the outcome can be tragic. In 2020, almost 20 percent of suicides were among people 65 and older, according to the U.S. Centers for Disease Control. And suicide rates for men over the age of 75 increased between 2008 and 2020, compared to rates for other age groups. Perhaps more frightening, older people are far more likely to be successful at a suicide attempt than younger people, according to research reported in the journal Psychiatric Clinics of North America.
Growing old can be hard and lonely, said Jennifer Marlin, a nurse practitioner who works in outpatient services with Cape Cod Healthcare’s Centers for Behavioral Health.
“The biggest issue they mostly have is isolation, loneliness,” she said. “They aren’t as engaged as they used to be. They can’t drive, or they don’t drive as well. They have mobility issues.”
Marlin manages medication and sets up therapy for behavioral health patients at both the Centers for Behavioral Health on West Main Street in Hyannis and at the Fontaine Medical Center in Harwich. She consults with patients struggling with mental health issues such as depression, anxiety, bipolar disorder, schizophrenia and affective disorder. When it comes to older patients, she finds that men tend to struggle more than women.
Many Triggers
“I think it’s really a generational thing,” she said. “A lot of these individuals are in their 70s or older, and I think men are what they do. So if they can’t [work], they feel like they’re not as connected and they lose their connection to each other. Women will get involved in groups.”
But she sees older women, as well, she said. “Some of them have histories of trauma, so large groups are not safe or comfortable for them. Sometimes that impedes them going out.”
Loss is a big issue for older patients, she said.
“I work with a number of individuals who have lost children, who have lost their spouses, and they’re just devastated, especially if they have lost a child to substance abuse,” she said. “Then they are losing friends. … And that loss really wears on them because they don’t have anywhere to turn to.”
And so is financial insecurity. Some only have their Social Security, and might not be able to even afford their medications, she said.
“All of that makes it hard for them to get up in the morning. I have had many people say to me, ‘I don’t have a purpose. There’s no reason to get up in the morning.’”
Families should be watchful for increasing isolation; a focus on regrets, a declining interest in a hobby or favorite activity; obsession with giving away tools or other objects; substance abuse; and/or physical changes, such as a weight change or lack of self-care.
What You Can Do to Help
If you’re worried about an older family member who doesn’t seem like their former self, here’s advice on what to do from Marlin and other experts, such as the Administration on Aging.
- Start with their primary care physician to rule out physical issues such as a metabolic imbalance. “If their blood work is off, it can cause them to have confusion or to have depression,” Marlin said. Discuss if mental medication, such as an antidepressant, might be appropriate.
- Do what you can to decrease someone’s isolation or give them purpose. That could be as simple as regular phone calls.
- Be aware of how a major life transition – retirement, death of a spouse, serious illness – is affecting someone’s mental health.
- Check on medications and make sure any no-longer-necessary or expired medications are disposed of at the police station or pharmacy and are not being stockpiled.
- Check on access to firearms. Seventy percent of suicides among those 65 and older were committed using a firearm, according to a report in the Journal of Community Health.
- Ask the primary care physician for a referral to mental health care or reach out to the following resources:
- Admissions to acute services:
508-726-2911
- Admissions to outpatient services:
508-790-3360
- Samaritans: Answer the calls for the 988 hotline
