Friday, March 1, 2013

If you think Suicide in the Elderly is Courageous? Think Again!

By Jean Echlin

In February of this year, a national paper printed an extraordinary posthumous letter from a 91 year old woman who died by suicide because she was tired of living. She wanted to end her life with dignity. Though most of the (published) responses thought she was courageous, I disagree. I believe there is more to the issue when anyone contemplates suicide.

Ultimately suicide in the elderly is a failure. We must ask ourselves, is it because pain and suffering were not addressed? Did individuals thinking of suicide, and their families, not have access to help and support? Is it because of societal ambivalence about mental health issues or stigma about the elderly? Is it due to encouragement and even pressure by pro-suicide groups like Dying with Dignity? What is the future of this legacy?

Rory Butler
Rory Butler, founder of award winning agency Your Life Counts (www.yourlifecounts.org), and a suicide survivor himself, asks: 
“what message do the elderly convey to our youth if they advocate suicide? Adversity and physical discomfort are not the sole preserve of the elderly. So often I hear their family will ‘get over (their suicide)…’ but my experience has shown that families often struggle with this loss for the rest of their lives.” 
Rory notes that individuals in families who have lost a loved one to suicide are at a 30% increased risk of suicide.

Further Butler says: 
“instead we should give our youth the message that adversity, pain and struggle are part of the life cycle…that’s what it means to be human…so persevere, press on, don’t give up!  Yet we hear some grandparents say it’s okay to give up. Ultimately suicide is the triumph of pain, fear and loss over hope.”
World renowned Dr. Antoon Leenaars (Windsor, ON), preeminent psychologist on suicide says: 
“it is a myth to think that courage motivates suicide. Genuine courage is to change what we can. Underlying suicidal feelings of the elderly are hopelessness, discouragement, illness but always and especially despair. They see no alternatives. They see their lives as meaningless. They think ‘I might as well be dead.’”
He notes 
“it takes a community to help individuals find meaning when they feel they have no meaning. Their pain is immense. We must find a way to give them hope. Medication, therapy, hospice, family, community – all can help.”
Tim Wall, executive director, Canadian Association for Suicide Prevention (CASP) in the report Not to be Forgotten: Care of Vulnerable Canadians, from the Parliamentary Committee on Palliative and Compassionate Care stated:
“What is especially tragic is that suicide can be prevented with compassion and access to appropriate services 
In fact most people who are suffering and at risk for suicide can recover and experience a meaningful and hopeful life.”
Aging brings challenges. These may include loss of independence, chronic discomfort/ pain, even chronic illness. Do these problems mean our lives are no longer of value?

As someone advanced in years living with chronic pain, and who has been with hundreds of people at the end of their lives, I know that aging is a daily struggle with its own share of joy and hope. I believe advancing in years does not diminish the value of our contributions.
   
Jean Echlin, RN, MSN
Nurse Consultant-Palliative Care & Gerontology
Jean Echlin was the founding Vice President of the Euthanasia Prevention Coalition.

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