Question: After a bout with cancer, my 93-year-old mother had to give up her apartment of the past 35 years and move into a nursing home. During a recent visit, she was miserably unhappy about her situation and said she was scared about what she might do to herself. I worry that she's thinking about suicide. What should I do?
Answer: Family members who suspect a loved one is contemplating suicide often keep silent in part because they mistakenly believe that discussing suicide will cause suicide. Experts, however, caution that silence can lead to tragic results. According to a 1988 report by the American Association of Retired Persons (AARP), the suicide rate for people age 65 and older is 50 percent higher than that for the general population. Older adults commit suicide for a variety of reasons including loneliness, despair over ill health, intractable pain, grief over loss of a loved one and fears about losing financial security. Older white males have particularly high suicide rates, as much as 4 to 12 times higher than older women, in part, say experts, because they have difficulty living alone in late life.
The AARP report notes that the elderly often take their lives quietly, "with few pleas for help." If they drop hints, however, family members and friends should respond. "People thinking about suicide are generally ambivalent and want someone to intervene," says Dr. Gary Small, a psychiatrist at UCLA.
Warning signs for suicide include statements such as your mother's allusion to hurting herself. Other signals include:
- Self-neglect, including neglect of grooming, eating and taking medications.
- Sudden attention to putting affairs in order, such as giving away possessions or preparing a will.
- Unusual interest or disinterest in religion.
- Statements that indicate the person is preparing for a long and distant trip.
- Nonchalant or careless reactions to bad news from a physician.
If you note any of these signals, or have other reason to suspect a loved one is considering suicide, express your concerns to the person. You should also consult a mental health professional such as a psychiatrist or social worker as soon as possible for expert advice. In some cases, a suicidal person must be hospitalized, sometimes against their will, to prevent them from harming themselves.
The importance of intervening to prevent suicide is underscored by the fact that most individuals who think about killing themselves are depressed, according to Dr. Small. And, he emphasizes, depression is a treatable illness.
It's a good idea to ask your mother's doctor to evaluate your mother for depression and appropriate treatments.
Question: My wife and I are in our 70s, in good health, active and travel often. We try to watch our diet but sometimes we both feel bloated after eating. Any suggestions?
Answer: According to Dr. David Reuben of the UCLA Claude D. Pepper Older Americans Independence Center, the amount of hydrochloric acid that is secreted in the stomach to help digest food decreases as people age. Consequently, it takes longer to digest and absorb food, giving many older people a bloated feeling.
Professor Helen Rasmussen, a nutritionist at Tufts University, says: "If you are eating three meals a day, you might do your body a favor by spreading those three meals into six minimeals." Dr. Rasmussen says research has shown that eating smaller but more frequent meals is a more nutritionally sound way of eating, for people of all ages.
One simple way to plan your meals is to make sure you include the nutrients you need by selecting from the four basic food groups. Unless you are on a special diet this generally means each day: At least two servings each from the dairy and meat group (for example, 1 cup of milk, 11/2 ounces cheese, 3 ounces of chicken, fish or turkey and 5 ounces of tofu). And at least four servings each from the grain and the fruit and vegetable groups (for example, 1 cup of cereal, one muffin, 1 slice of bread, 1 cup of noodles, rice or pasta; and 1 cup of broccoli, 1 medium potato, an orange and tomato juice).
Try planning a menu for a few days that includes these four basic groups. Then spread it out over six smaller meals. Keep a record of what you eat. After a week, you should be feeling less bloated.
Because an inadequate diet can result in poor health, lack of energy and even malnutrition - an increasing problem for older people especially those living alone - it's important to periodically evaluate your nutrition. Try to develop new eating patterns and experience new food if necessary to meet your need for good nutrition.
It is also important to drink enough liquid. Experts recommend at least eight glasses of water a day. Exercise also helps improve digestion.
At your next physical examination, you might want to discuss your diet with your physician.