The Four D’s of Suicide Risk in Older Adults

The Four D’s of Suicide Risk in Older Adults

one thing that people don’t recognize
is that worldwide men and women as they get older are at greater and greater risk
for suicide. I think it’s important and helpful to know that there are just a
few things that we associate with suicide in older adulthood that really
can be fixed and when we change those things, when we recognize them and then
intervene, that trajectory toward suicide actually can be altered and lives can be
saved. The things that pop out that place older adults at risk our first
Depression and by that I mean clinical depression. Older person with clinical
depression typically is going to be sad they’re going to have lost interest in
things that commonly interest them. They might be anxious, they might have trouble
sleeping, they might have lost their appetite, feel a lot of somatic symptoms as we call
them things like pain and stomach upset The 2nd “D” is Debility. It’s the idea
that even though older people ordinarily almost have one or more chronic
illnesses, when that illness or illnesses mount up when they begin to have an
impact on the person’s functioning, their ability to maintain independence,
and in particular has impacts on things that are personally meaningful. The third
“D” as I think about it is Disconnectedness. We know that it’s very important for older
people to maintain social contacts and social connections and so if an older
person is withdrawing from or is required to withdraw from social
interactions because of physical illness and functional impairment, that disability,
or because they’re depressed and it’s hard to interact with other people,
that’s an additional risk. The fourth “D” I think of as access to Deadly means. Over three-quarters of older men who take their own lives do so with a firearm and of
older people, older people over the age of 65 who die of a firearm injury each
year ninety-two percent are suicides. So
having a firearm in the home we know of an older person who has these other “Ds” going on in life is at significantly increased risk. Older adults it is not a time when it’s
normal to feel depressed, it’s not a time when it’s normal to feel as if your life
has no meaning and if those things are coming across that should send up a red
flag and indicate a time for some additional evaluation because these are
things that can be changed.


  1. As our health (sometimes) declines, as more of our friends & loved ones pass away, depression is a real concern. We are no longer active in childcare, we feel more and more isolated. This is the time to actively combat those feelings, stay close to family, keep making friends and stay socially connected.

  2. I wish someone brought awareness to me about this at the hospital when they let my grandpa go home before he was able to care for himself … And the staff at the hospital humiliated him by making faces and avoiding cleaning him after and already very degrading situation…. He would have recovered full controll and regained his strength in time… It's not like he was terminal… I'll never forgive myself for seeing his gun in the closet the last night I stayed with him… and not moving it and putting it away someplace he couldn't get to it for a while…. It never occurred to me he would ever actually do anything to hurt us…. Or himself… And now I will never see him again… How do I forgive myself for that? My grandfather was the best person I'd ever met in all the world. Now we are all with out him because of me. I am the one who deserved to die. Not my grandpa… It really bothers me that me might have died believing that I didn't love him….or that I wasn't worth sticking it out for after we burried pretty much everyone else together… Now I only have my mom left and after finding his body… I irrationally fear she may be inclined to do the same every time she goes to bed…. If anyone is considering this… I desperatley wish I could change this… I'd have done anything for my grandpa even give him my good kidney. Taking care of him would be something I'd have been so grateful for after everything he's done for me .. as long as he was still here to take care of.. it didn't matter that much… I wish he would have talked to me… I feel really sad that he suffered so much and never reached out to me… I really wish more then anything he would have just given me the chance.. bit there isn't anything anyone can ever do to change this now… I will most likely feel responsible for this… And burden this hurt unbearably in my soul for all my time here.. and possibly even beyond…

  3. Of course it's a normal time for people to be depressed – our culture hates and fears older people, they are marginalised, denied the ability to meaningfully contribute, are condescended to by just about everybody, and basically made to feel invisible and worthless. And that isn't depressing? It always pisses me off when a (relatively) young person says it's not normal to be depressed in old age

  4. I won't be showing this video to my kids. They may take away my right to do as I need to do at my choice and without humiliation and stupid platitudes by others. I will claim my dignity in death since I can't get it in life by others who don't see what they do and say.

    I was left with no money when my second husband died, no medical, no social security, no $ because I was a stay at home mom and homeschooled. I was traumatized horrendously by my deceased husband's family, leaving me unable to face people out of fear of more humiliation and disrespect of my good character. I had a life of little support, but gave up so much for others. Frankly, I'm sick of being here. People do not care about older people. People won't hardly talk to older people, leaving them isolated. Then the media saying there's no afterlife, while stupidly philosophiizing with their full bellies and pockets, making life look both unjust and meaningless for people who don't have the means to live out their lives. The afterlife people have such an array of fantasies and stupid platitudes, how can anyone believe them? Churches are devoid of compassion. This goes on and on. Afford dental work so you can eat properly, or repair an old car so you can get around? Forget it. Have your neighbors call code compliance rather than mow a lawn for an elderly? Forget it. There's more reasons to kill oneself than stay alive. Reality is one ugly sticking bitch. This guy superficially covers the subject. He talks like a removed professional analyzing older people like we're an ant farm being observed in a homemade tank. But it's an improvement over the many who don't even address this topic. Americans are too self absorbed.
    I gave this video a thumbs down.

  5. I can see why it's the only solution. if you're not in the same place as someone considering the option, then you'll never get it. I think I get it.

  6. Oh geeze my life hasn't had making since 2000, living in subsided housing with old bitter women. Next time a tiny home.
    P.s. just adore male shrinks telling us? I'm sick of Men thinking they know better ….

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