THE ELDERLY AND SUICIDE

Robin Williams’ suicide should serve as a wake up call for many of us who did not understand how depression affects older adults. It is estimated that 6.5 million of the 35 million adults over the age of 65 suffer from depression. This seems to be, in many instances, attributed to loss of independence, acknowledgment of one’s mortality, disability and loss.  In the case of Robin Williams, it is speculated that his Parkinson’s diagnosis may had been a factor in his decision to commit suicide.

The Center for Elderly Suicide Prevention reported that the rate of suicide for the elderly for 2007 was 14.3 per 100,000. White men over the age of 85, were at the greatest risk of all age-gender-race groups. In 2007, the suicide rate for these men was 45, 42 per 100,000.

According to the Center for Disease Control, suicide rates among older adults is believed to under-reported. In fact, men in their 50’s and early 60’s (Robin Williams’ age bracket), the rates have increased. It is interesting to note that though young people make more suicide attempts, older adults are more successful in carrying it out. This is a result of the lack of the physical acumen they once possessed.

Depression seems to be the most causal symptom of suicide among this group.  Also, the fear of appearing helpless, not feeling valuable or wanted also leads older adults to comtemplate suicide. It is so important that family members and friends observe signs of depression and social isolation. Here are some warning signs from the American Association of Marriage and Family Therapists (AAMFT):

  • Loss of interest in things or activities that are usually found enjoyable
  • Cutting back social interaction, self-care, and grooming
  • Breaking medical regimens (such as going off diets, prescriptions)
  • Experiencing or expecting a significant personal loss (spouse or other)
  • Putting affairs in order, giving things away, or making changes in wills
  • Stock-piling medication or obtaining other lethal means
  • Other clues are a preoccupation with death or a lack of concern about personal safety
  • Remarks such as “This is the last time that you’ll see me” or “I won’t be needing anymore appointments” should raise concern.
    The most significant indicator is an expression of suicidal intent.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov. Please feel free to leave your questions or comments.

References:
American Association of Marriage and Family Therapists
Center for Disease and Control
Center for Elderly Suicide Prevention

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MAKING THE HARD DECISIONS FOR YOUR AGING PARENTS

When one realizes that their parent is starting to exhibit signs that they need help, decisions must be made. It is probably the most tragic thing to witness. To think that this person that raised you into an adult is now is need of care is heartbreaking.

Many times the parent is in denial and will become obstinate and refused to admit help is needed. I have learned that you cannot engage in an argument. You must first have empathy for the hand that was just dealt to them.

The very idea of relying on someone for assistance for a parent is scary. That parent is being asked to take a risk and let someone intervene in decisions that they have made years prior. As an adult child, you must understand their plight and also help that parent feel a sense of independence and pride.

Dr. Rob Crankshaw made this suggestions:

  • Give elderly parents every opportunity to continue to make their own decisions. It may take a crisis, but at some point it will become clear to all involved that a change in level of care is necessary.  Hopefully the crisis will not result in permanent physical damage.
  • Recognize that sweeping changes may not be necessary.  Sometimes smaller modifications like Occupational Therapy or a change in medication may be all that is needed. (that was hard for me because I became fixated on making it work now).
  • Be aware of your parent’s possible feelings of embarrassment, shame and impotence as more decisions are made for them.  Use humor, self-deprecation, and a positive outlook to help the elderly from focusing on their loss of independence.  Find a positive side of any negative occurrence without belittling what elders are going through (this may be the most important suggestion).

We forget, during our pubescence, our parents would become objects of embarrassment. We did not walk them to walk us to school or show public displays of affection. Our parents, despite their hurt, took  it on the chin knowing that we were trying to become independent. I would encourage adult children to remember that image and exercise patience with your aging parents.

I also caution adult children that if they need support to seek it out.  Adult children who become frustrated often turn into becoming abusive to their parent.  Share the load with your siblings, if you have them.

I want to add something I heard watching the Queen Latifah Show.  Swoosie Kurtz, the famous Broadway, movie and TV star, is taking care of the mother. Her mother has a “touch of dementia”, as she refers to it. One day her mother asked her if she was in the way. Her response was, “no mom, you are the way.”  To me, that says it all.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

Please feel free to leave your questions or comments.

WORLD ELDER ABUSE AWARENESS DAY

Depression in Older Adults and the Elderly

June 15, 2014 is World Elder Abuse Awareness Day. This day was created in 2006 by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations. The very idea behind WEAAD was to promote a better understanding of abuse and neglect of older persons. It was intended to show that this health concern is a global concern regardless of race, culture, social or economic status.

In the past, many communities groups developed educational programs or press conference, organizing visits to the elderly and writing articles in local newspapers. Here are some facts about elder abuse from a global perspective:

  • In many parts of the world, elder abuse occurs with little recognition or response. Until recently, this serious social problem was hidden from the public view and considered mostly a private matter.
  • Elder abuse is a problem that exists in both developing and developed countries yet is typically underreported globally. Prevalence rates or estimates exist only in selected developed countries ranging from 1% to 10%.
  • Around 4-6% of elderly people have experienced some form of maltreatment at home.
  • Elder maltreatment can lead to serious physical injuries and long-term psychological consequences.
  • Elder maltreatment is predicted to increase as many countries are experiencing rapidly ageing populations.
  • The global population of people aged 60 years and older will more than double, from 542 million in 1995 to about 1.2 billion in 2025.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

Please feel free to leave your questions or comments.

Reference:

World Health Organization

THINGS FOR CAREGIVERS TO CONSIDER

One of the hardest decisions an adult child/children must make is whether or not to place their parent(s) into a nursing home. There are feelings of guilt and failure attached to such a major decision. This is why careful analysis of this life-changing decision is important. Many decide to keep their parents at home because they feel that it is the right thing to do. However, there are some important considerations.

Many elderly loved ones want to remain at home because of the memories attached to belongings and their residence. They also have a sense of community with long-time neighbors. However, there are issues that may be of concern such as cooking, cleaning, toileting, shopping, doing laundry, and driving, as well as falls, which for frail elders could prove to be problematic.

One has to ask oneself if family members, friends, or neighbors will be available to take care of the specific thing the elder has trouble with — such as doing laundry or shopping. Also, someone must be available to accompany the elder to doctor appointments and other appointments. The elder may need assistance in maintaining the residence and paying bills timely.

If one chooses to become a caregiver, they are some dangers for the caregiver to contemplate. According to http://www.webmd.com, caregiver burnout is a serious problem. It is a “state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned.”  This a result of a caregiver don’t get the help they need, or if they try to do more than they are able — either physically or financially. Guilt and inadequacy are the final result. Here are the symptoms:

  • Withdrawal from friends, family, and other loved ones
  • Loss of interest in activities previously enjoyed
  • Feeling blue, irritable, hopeless, and helpless
  • Changes in appetite, weight, or both
  • Changes in sleep patterns
  • Getting sick more often
  • Feelings of wanting to hurt yourself or the person for whom you are caring
  • Emotional and physical exhaustion
  • Irritability

Scott Eckstein was an Executive Director of an Assisted Living Facility for 20 years. He has witnessed many adult children in tears about the challenges of being a caregiver. He suggests the following:

  • Find a support group or network. You may be surprised how many are out there and how many people are in the same boat as you. Attend some meetings to receive feedback and learn coping strategies. Find the meeting that is a fit for you. Openly share your feelings and experiences with others.
  • Strongly consider speaking with someone you trust. Bottling all your tension up can lead to angry outbursts. It’s always good to hear things from an outside perspective, especially from someone not directly involved in your situation.
  • See your doctor or another professional to explore the burnout issues that are impacting you specifically.
  • If possible, vary the caregiving responsibilities. Rotate/share responsibilities with family members — demand it! It’s really okay to ask for help. You have to accept the fact that you cannot do everything yourself, otherwise you’ll end up being the one that needs to be cared for.
  • Put time into taking care of yourself emotionally and physically. Be sure to get enough sleep, maintain a healthy diet and get some sort of exercise each day.
  • Make room for “Quiet” or “Me Time”.  Meditate, get a massage, see a movie — whatever does it for you. Just do it!
  • Stay involved in hobbies or other outside interests. All work and no play…you have heard it. It applies to care giving too.
  • Acknowledge caregiving is filled with stress and anxiety. Understand the potential for burnout. As a caregiver, you need to be on-guard against succumbing to burnout. It may be cliché, but it cannot be said often enough: “The best way to be an effective caregiver is to care for the caregiver.”

Why does this require careful consideration? Studies have shown that loving caregivers can become abusers if they do not take care of themselves first in order to be effective and loving caregivers. To those who are caregivers of older loved ones, you are charged with the responsibility of  helping them maintain their quality of life.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

Please feel free to leave your questions or comments.

References

http://www.care.com

Eckstein, S. (2011). 8 tips to combat caregiver burnout. Alzheimer’s and caregiving, 2011

http://www.webmd.com.

THE ELDERLY AND DEPRESSION, PART II

 I have been writing about elder abuse and protecting the elder. In this process, I have learn so much and I hope that this journey has helped those who read this as well. I really did not fully grasp the plight of the elderly until I noticed my mother’s struggle with grief.

My mother has been the rock of my family and now since she has suffered a bout with depression after suffering the loss of the mother, niece and brother, I painfully watched the woman I love so much become a shell of who she was.

I did not know that I had to become her champion and protect from potential predators. There were those who tried to say that she was suffering from Alzheimer’s or dementia. I kept saying that they were wrong and was accused of being in denial.

When she started having hallucinations, I took her to the optometrist to make sure that she was not suffering from Charles Bonnet Syndrome, which is the experience of complex visual hallucinations in patients with visual loss.

I later took her to her primary doctor. This man was the kind of doctor that anyone who had a medical problem would love to have, comforted her and assured her that she was not crazy. He told her that she was taking on too much and learn how to say no.

I took her to a psychiatrist and she explained to my mother that depression at her age is different. This is a result of losing those in her peer group, i.e. siblings, cousins, etc. She also suggested that she stop isolating herself and start socializing. This made all of the difference to her. I can report that she has been significant progress.

I tell this story about my mother because there were those who cruelly validated her hallucinations and told her that they were real, her  money was stolen and she was in fear. This, in my opinion, is definitely abuse.

To those who are caretakers of older loved ones, you are charged with the responsibility to champion their survival and helping them maintain their quality of life.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

Please feel free to leave your questions or comments.

THE ELDERLY AND DEPRESSION

NOTE: I, along with my managing attorney, E. Nego Pile, of the Pile Law Firm, a law firm specializing in Elder/Estate Law in the Greater Philadelphia area, thought that this topic was important to address because of the potential danger of many seniors being misdiagnosed as suffering from dementia or Alzheimer’s Disease.  Attorney Pile recommends that before petitioning the Court for a guardianship action, make sure that you do your due diligence to ensure that your loved ones are not suffering from depression. Guardianships should be a last resort.

It is also important to note that depression can lead to self-neglect, which is one of the most pervasive forms of elder abuse. 

My mother recently lost her dear brother. She lost her mother 2 ½ years prior to that. She agonized over their deaths because she was caregiver to both her mother and brother.

I noticed that some of my family members felt that she should have mourned sufficiently and she should “go on with her life”.  She started exhibiting signs of social withdrawal, memory loss and she always seemed disoriented.  No one bothered to even consider that she was experiencing depression. Depression is an illness that affects many seniors. Unfortunately, this illness is more common in seniors that many of us may know.

According to the National Association of Mental Illness (NAMI), 6.5 million of the 35 million adults over the age of 65 suffer from depression. There seems to be, in many instances, attributed to loss of independence, acknowledging one’s mortality, disability and loss. The danger of depression is that many times it is misdiagnosed as dementia. This may be a result of the following characteristics:

  • memory loss
  • confusion
  • social withdrawal
  • loss of appetite
  • weight loss
  • complaining of pain
  • insomnia
  • irritability
  • delusions
  • hallucinations

The good news is that depression is treatable. Depression is a chronic disease. As Dr. Ken Duckworth of NAMI states “getting well is only the beginning of the challenge—the goal is staying well. For people experiencing their first episode of depression later in life, most experts would recommend treatment for six months to one year after acute treatment that achieves remission.”

My mother’s experience taught me a valuable lesson. Adult children need to understand the emotional and physical adjustments our parents are experiencing. This adjustment can be frightening and daunting. Imagine not knowing which of your children will treat you disrespectfully and become abusive. Consider the fear of one of your children stealing your money, selling your home or declaring you incompetent.

It is easier to dismiss our parents’ struggles and label them as “old and cranky” or just senile. The next time you become aggravated by your aging parents, grandparents and older family members, just remember how you want to be treated when you reach their age. Let’s hope many of us live to reach their ages!

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

Please feel free to leave your questions or comments.

Reference
National Association of Mental Illness. Depression. Retrieved from http://www.nami.org.

SWEDEN, AN EXAMPLE FOR THE WORLD ON HOW THE TAKE OF THE ELDERLY

The elderly people in Sweden is a growing share of the Swedish population. Many are in good health and lead active lives, and most live in their own homes. Many say that elderly care in Sweden is the best in the world. Sweden invests more of its gross domestic product in its elderly than any other country in the world. According to http://www.sweden.se, Sweden’s allocation to elderly care is almost five times the European Union average.

It is estimated that In 20 years’ time, one Swede in four will be over 65, and most of the people in this age group will be active and healthy. Several initiatives aimed at meeting future needs are now being put in place around the country. Sweden has been invested SEK $4.6 billion ($702,277,400 in US) measures to improve health and social care for the most infirm members of the 65+ age group. The aim is to improve coordination of home health care, elderly care, hospital care and health-center care provided to elderly people.

In terms of home care, the government offers assistance from the local government to elderly persons who are no longer able to cope with the demands of everyday life.  The care provided is accessed by need. Elderly people with disabilities and those who are severely ill can receive assistance around the clock, which means that many are able to remain at home throughout their lives.

As I always mention, please report all incidents to the proper authorities. You can also find information on the National Center on Elder Abuse’s website at http://www.ncea.aoa.gov.

If you live in Philadelphia, PA or the surrounding areas or in the State of New Jersey, you may contact the Pile Law Firm at 610-718-6368 for assistance in elder law and estate planning matters. The website is http://www.pilelaw.com.

Please feel free to leave your questions or comments.