Senior Health

8/23/2022 | By Terri L. Jones

Seniors Guide looks at a serious but often overlooked problem among older adults: senior suicide. We consider the causes, signs, and prevention steps – including the new suicide hotline – as well as insurance coverage for mental health care.

When we consider the issue of suicide, we tend to think about young people and middle-aged adults dealing with problems such as relationships gone wrong, job loss, legal troubles, or drug addiction.

But the fact of the matter is that seniors have some of the highest suicide rates in the country. According to 2017 data from the Centers for Disease Control and Prevention, the suicide rate for people 85 and older was much higher than those aged 15 to 44 and more comparable to those in the prime of life: 45-54. Out of the more than 47,000 suicides in the U.S. that year, over 8,500 were senior suicide, committed by people 65 and over, with men in this age group at highest risk for taking their lives.

When a senior attempts suicide, they are more likely to die than their younger counterparts – 25 percent compared to .5 percent – reports an NPR story on senior suicide. This higher rate of “successful suicides” is due to a variety of factors, including frailty, more careful planning, or being alone in their homes, lowering the possibility of rescue.

So, why are so many older adults resorting to suicide?

The CDC estimates that 20 percent of those over 55 are experiencing some type of mental health issue – the most common being depression and anxiety. However, 87 percent of suicide victims who had a preexisting mental health issue had not sought out professional help before their suicide.

Other issues, such as loneliness and isolation (particularly during the COVID-19 pandemic), death of a spouse, financial concerns, chronic physical illness, and loss of independence, can cause mental illness to snowball and lead to suicide. A recent study also found that mild cognitive impairment and dementia, which can impact a senior’s decision-making, can increase their risk for suicide.

sad senior woman. photo by Rido, Dreamstime. Senior suicide is often overlooked. We consider causes, signs, prevention steps, the new suicide hotline, and insurance coverage.

Another contributing factor for many seniors is feeling overlooked and ignored. In the NPR story, 72-year-old Sheri Adler, who attempted suicide in 2019, said that being old has a stigma attached to it and makes people not want to talk to you.

Spotting the signs

You’d hope that you’d recognize if a loved one was contemplating suicide, but sometimes the signs aren’t as obvious as stockpiled medication, a gun purchase, preoccupation with death, or statements like “you’d be better off without me.” According to the National Council on Aging, other signs among older adults considering suicide may include:

  • Revising their will
  • Giving away possessions
  • Withdrawing from people
  • Losing interest in favorite activities
  • Neglecting grooming or medical care
  • Sleeping more or less
  • Using alcohol or drugs on a more frequent basis

The American Foundation for Suicide Prevention also advises paying attention when seniors talk about being a burden or tell their loved ones goodbye.

Heading off a tragedy

If someone you know has exhibited signs of suicide, the National Suicide Prevention Lifeline (as reported in the NCOA) recommends taking the following steps:

  1. Ask. Come right out and ask the person if they’re considering suicide and how you can help. Validate how they’re feeling but remind the person of why their life is worthwhile.
  2. Be there. Try to be there for them in person to minimize their feelings of isolation. If you can’t be there in person, connect via the phone or a video call.
  3. Keep them safe. Find out if the person has a specific plan or has attempted suicide before. Do they have access to drugs or weapons to harm themselves? Answers to these questions can help you determine if the person is in imminent danger and if you need to reach out to The National Suicide Prevention Lifeline using the new universal dialing code, 988. This easy-to-remember phone number connects the caller directly to counselors 24/7. This hotline is free of charge and can be used by phone or text.
  4. Help them connect. Make sure the senior has access to mental health assistance. If they don’t have a therapist, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a valuable directory of mental health providers across the U.S.
  5. Follow up. Once you’ve talked with the person and ensured they have support, be sure to check back in with them – in person, by phone or text, or even with a card. Simply reaching out will show the senior that you care and may ultimately keep them alive.

Call 988

The National Suicide Prevention Lifeline offers new universal dialing code, 988, to connect the caller directly to counselors 24/7. The hotline is free of charge and can be used by phone or text, for those considering suicide or those concerned about someone who is.

Understanding insurance and Medicare coverage

Inpatient or outpatient mental health care is typically covered by both Medicare and commercial health insurance (see your plan for details).

However, after an actual suicide attempt is made, there may be some gray areas in coverage.

According to the National Alliance on Mental Illness (NAMI), insurance plans covered by the Health Insurance Portability and Accountability Act (HIPAA) must cover the costs associated with attempted suicide, but only those costs that are typically covered by the plan and only if a physical health condition or mental health condition triggered the suicide. (Medicare is covered by HIPAA.)

NAMI’s publication, Navigating Health Insurance Following a Suicide, provides the following example: “If a person attempts suicide due to depression or schizophrenia, the health plan cannot deny payment for services that would otherwise be covered. This means that if emergency room services are typically covered by the plan, the plan cannot deny emergency room services for a self-inflicted injury. However, if the plan excludes certain services, such as physical therapy, then the plan can legally deny coverage for physical therapy to treat an injury.”

No one wants to believe that suicide could happen to someone they love; however, no one – no matter their gender, life situation, or age – is immune to this possibility. The key to preventing this devastating outcome is to remain alert and not be afraid to act. Your awareness and action could save a life!

Terri L. Jones

Terri L. Jones has been writing educational and informative topics for the senior industry for over ten years, and is a frequent and longtime contributor to Seniors Guide. She also writes for many other local magazines and publications.

Terri Jones