Official data indicate that the highest suicide rate in Spain occurs among people over 80 years of age. However, it is difficult to find survivors – their families or friends – in the support groups that exist throughout the country. They are invisible deaths, particularly difficult to prevent and with few unsuccessful attempts, agree all the experts consulted. The new Action Plan against Suicide that the Ministry of Health is finalizing includes this group among those who require priority attention because they are “particularly vulnerable” to suicide. The majority are men.
“There is a huge feeling among family members of having left the person alone. It appears all the time. The majority of people who call on our resources are wives or daughters who have deeply internalized the role of caregivers. So this guilt of thinking that they did not know how to do it, that they were not present as they should be, is very complex in the duels,” explains Carles Alastuey, educational psychologist and head of the support groups of the DSAS association (After Association of Suicide Survivors).
The question that arises in the face of the strength of the data – 16.1 deaths per 100,000 inhabitants, twice the number of deaths occurring in the thirties – is whether care resources are not reaching the elderly. The reality, experts point out, is a little more complex. “Ageism confuses us and we identify psychological problems with age problems. Since you are older, it is normal that you are angrier and sadder. Sometimes it seems that we privilege the elderly from the complexity of the human being or that we think that old age itself is the cause of suicide,” explains Irene Lebrusán, a doctor in sociology and researcher at the International Center on Aging (CENIE).
The problem, due to these preconceived ideas, is often the difficulty in detecting the warning signs. “Taking certain things for granted, such as the fact that being older means being sad and deteriorated, makes it difficult for us to see it because we naturalize it,” recognizes Raimundo Mateos, head of the Psychogeriatrics Unit at the University Clinical Hospital of Santiago de Compostela.
“We must ask for more”
“Many elderly people do not complain of sadness, but of their body, of the fact that things hurt them. And if the health worker does not know that the alert could come from there, he will not realize it. They do not tell you that they are desperate or that life has no meaning. You have to ask for more, have an attitude of dialogue and vigilance because in the elderly, depression can be a prelude to suicide,” explains the psychiatrist.
This lack of very obvious warning signs is also recognized by Javier Jiménez, psychologist and founder of the association RedAIPIS, which works on research and prevention of suicidal behavior. “These are people culturally less familiar with mental health problems. When talking about it, especially men.
Added to this is the fact that they have fewer attempts at self-harm than other age groups. They don’t usually fail, so the rate goes up. And the impact on the survivors around them is brutal because it can be unexpected. “In therapy, you see adults who are independent and who are very deeply affected by the loss of their very elderly parents. They needed them, even though the person who commits suicide may think they are replaceable,” he adds.
Homogenizing the elderly is an exercise that is not recommended, warns Mateos, who on the contrary assures that in this age group there is even greater diversity than in others. But there is research that has tried to address suicide in the elderly and affirms that depressive disorders are one of the main risk factors in this group. Added to this are serious physical illnesses, family conflicts, recent losses, loneliness or living alone, lists a study published in the Spanish Journal of Public Health in 2021.
These are the “stressors” that frequently occur at these ages and if they are not accompanied by support, the risk increases, continues the psychiatrist. “In what we talk about so many times about the loneliness of the elderly, we are not only referring to an objective loss of social support, but above all to the subjective part. This is the important point: the lack of perceived social support. They can be super cared for and accompanied in their physical ailments but nothing more,” explains Mateos.
According to the Continuous Household Survey of 2020, the latest year for which data is available, 44.1% of women over 85 lived alone in Spain, compared to 24% of men. In 2013, this percentage was 34%, ten points lower. Living alone is not the same as suffering from unwanted loneliness. They do not always go hand in hand.
A study by the LaCaixa Foundation among people who visited senior centers in 2021 revealed that almost 70% suffered from some form of loneliness. In the majority (53.7%) it was “moderate”, while in 10.3% it appeared as “serious” and in 4.5% as “very serious”. Of all the seniors surveyed, 41% lived with a partner, 34% lived alone, 12% with a spouse and children and 7% only with descendants.
The research also highlights two perverse socio-cultural problems that emerge when faced with the suicide of a very old person: “Traditionally, it has been considered less relevant, even underestimated” and “the perception that death has a low economic impact on the community.” low because this population group is not part of the working population.
While the gender gap in suicide is present at all ages, it skyrockets among older people. It’s a problem that has long been studied for older people, and it even has a name. Anthropologist Benno de Keijzer calls it “system breakdown.”
“The retiree finds himself without his place-identity, very focused on his work, and he finds himself without a project because he has not built it or prepared it. Many return home full-time without getting involved in domestic work or as a parent, as women do, whether they are retired or not. “Women also manage to form more important and more diversified emotional ties than men,” she explains in this report. In the suicide data, “the mandates of traditional masculinity” for many men are put in black and white: “to be strong, not to ask for help, not to recognize vulnerability or to have a false conception of self-sufficiency.”
The transition from productive life to the end of it “is more difficult” for men, Lebrusán points out. “When we analyze the number of people who go out at a later age, we see that women traditionally tend to move in small circles and men explore the space more. When there is a break with this external space due to the end of work and for reasons of physical health, or both, there is a lot of impact,” analyzes the sociologist.
Although the trend of suicides being more frequent among the elderly is consolidating over time and does not vary much over the years, criticizes Mateos, “the academic and scientific world have been somewhat lazy in defining the instruments that we use to assess the mental state.” health of the elderly. The result is that there continue to be “many hidden pathologies.”
