Hacker News Reader

Comment by somedude895 | Hacker News Reader

> Men 75 and older had the highest suicide rate last year at nearly 44 per 100,000 people

This is so crazy to me. When I think of suicide I never picture a retiree taking his own life. There‘s a lot of talk about the mental health epidemic among teenagers. I wonder what causes this high a suicide rate among men 75+. Loneliness?

View on HN

Answered a similar question below. It's equally crazy to me that people wouldn't immediately understand the elderly having quality of life issues.

A few that came to mind: -chronic pain -immobility (walkers/wheelchairs etc) -mental decline (senility) -loneliness as you say (possibly addressed by mental decline but it's often cited as a major issue for the elderly) -exponential medical costs

There's probably a lot of other reasons as well I'm sure. What a drag it is getting old.

Yeah a married retired man down the street from me OD'd on pills ~10 months ago, what I heard is it was because of his chronic health issues.

The average American has hardly anything saved for retirement. So imagine living a spartan existence while your friends die off around you (if you even had many, men in the US largely don't), your body fails you in more and more ways every day. And it's not like you live in Manhattan and can go sit in central park and play chess or feed the birds with other people like yourself. You live in some rural area or lower tier city that is basically completely car dependent. There is no where to go, nothing to do, you are completely alone.

It doesn't surprise me in the slightest.

There is a crisis of people not having enough savings. That problem manifests more the older you get. That multiplies with how horrible US healthcare is if you're not well off, and the fact that you need more healthcare the older you get. That also multiplies with the problem of smaller/nonexistent close family/community groups that one could normally get help from. I imagine (though I have no studies to link) that this combination contributes significantly.

The strange part of this to me is that the elderly are the one group in the US who get universal, single-payer healthcare.

There are still co-pays and premiums (if not also on Medicaid). The availability or quality can be an issue.

I think the bigger factor is not the healthcare at that point but the lack of healthy living up to that point. There's not much that can be done for some conditions like dementia. There are many conditions though where people ignored their weight, sugar, etc for decades and there's not a magic cure, or the damage is already done.

Lack of purpose, I would guess.

Old men are currently expected to sit in nursing homes and watch TV until they die. Given how painful those years can be, there would be a lot of downside and no upside.

Even if families care about their elderly, the best most can hope for is affection. Whether they deserve it or not, there's not likely to be much reverence in our culture; nobody's really going to listen to them. While it's doubtful they were ever the defining authority in a family, they may have at least been consulted in the past. Now they are more likely to be viewed (rightly or wrongly) as a burden that nobody would even think to ask for advice or input.

The elderly people I’ve spoken to respond that they are a burden. No longer independent, can’t drive or not supposed to drive out of town especially at night, and once they become fall prone it gets very difficult to care for them.

They feel like a burden because we treat them like a burden. I am not elderly yet, but I’m treated the same way. Instead of people seeing my abilities, they only see my disability.

All people need to be integrated into their society.

It’s interesting as well as sad that a burden is defined as a load and a responsibility.

I suspect a large portion is to escape a health crisis, such as terminal illness or impending dementia. Mixed with skyrocketing healthcare costs, this also might be a way to bow out to not leave your family indebted with crazy bills.

Two things about why this is a perceptive observation: First, when looking at a systemic trend, look for systemic causes. For-profit, private sector health insurance is not a healthy market. Some markets need to die, before they kill more people.

Second, because the cause is likely systemic, don't blame or try to "fix" individuals.

> For-profit, private sector health insurance is not a healthy market.

Anyone over 65 would be on Medicare. It’s not exactly free, but it’s also not private.

I am on Medicare, and ever since 2007 It’s gotten worse and worse and worse to the point now or I can no longer get care or the test because doctors are so afraid of not getting reimbursed from Medicare.

Drugs can be expensive on Medicare because of the "doughnut hole". Ie, anyone on expensive drugs ends up paying around $7K-8K a year for drugs, on top of their Medicare premium and supplemental insurance premium, which together are anywhere from $200-500 per month depending on the plan.

https://www.medicareinteractive.org/get-answers/medicare-pre...

Medicare premiums increased 5.9% for 2024 ($9.80 increase from $164.90), while the 2024 COLA for Social Security benefits is 3.2%. So the longer you live, the worse your financial picture gets.

> I wonder what causes this high a suicide rate among men 75+. Loneliness?

Not 75, but old enough to have my share of chronic pain that just randomly comes with aging. Based on my subjective experience to date and extrapolating forward a bit, it's not hard for me to imagine a 75 year old being in enough pain to where that would be a major factor.

Also, I'd guess that cognitive decline is a factor. Speaking for myself, while my body doesn't work as well as it used to in some ways, my mind (so far as I can tell) still does. And the idea of starting to lose my mental faculties fucking terrifies me. And while I currently have zero plans to commit suicide now, or ever, I can take a step back and look at things and say that if/when the day comes that I feel like I'm starting to fade mentally, that might push me to the place where I could consider something like that.

I'd guess it could often be a natural conclusion when faced with a declining quality of life and little hope for improvement. If it's a well considered decision, I don't think it's necessarily a "mental health" problem that needs to be solved.

I personally enjoy life and have never had suicidal thoughts, but I also don't want to live forever if my health declines to the point where I'm in a miserable terminal condition.

Most of the people I know who committed suicide were older men diagnosed with dementia. They are making a rational (maybe not reasonable) choice to end things rather than live as a zombie.

Thanks, I hadn‘t thought of that. Certainly puts a different perspective on the statistics.

I dunno it sounds entirely reasonable to me. Everyone was sad when Robin Williams left us. I was too, but given his dementia diagnosis I completely understood and respected his position

I think what sounds reasonable would be mostly up to the individual and their situation, so I left it open ended. For example, one of them was in the very early stages and likely had a good year or two left before things got bad, so maybe they did it too early, or maybe not.

I shadowed at the county morgue for a few weeks a long time ago. When there was not an autopsy to observe, I was given access to their case files, which were color-coded by cause-of-death (natural causes/homicide/suicide/etc).

I spent one afternoon going through a couple handfuls of suicide cases and while I don’t remember many nitty gritty details, the thing that surprised me was seeing a lot of older men.

Their suicide notes were also primarily instructions on what their family should be doing with their assets/finance talk, that part has always stuck with me 2 decades later.

I am fairly sure its from a generation which was very attached to their spouses. They probably met their wife/husband when they were 18-20, and In my opinion lot of these men above 75 were suffering from death of their spouse or a good friend that they spent 2/3rds of their life with. Men are more vulnerable to emotional loss at that age and they are probably less connected with kids while women may just be holding on for seeing their kids even after the husband has died.

My mid 90s grandmother is waiting to die because she’s afraid of hell if she kills herself. She has family around her, she just doesn’t see any reason to stick around. Hard to walk for her but still can, not a burden at all, just nothing left she wants to do. My father, her son, early 70s divorced twice who lives with me (laid off recently, likely never to work again when that was his entire identity) is right behind her.

this was my great-grandmother. The last two years of her life were her just waiting to die, and if she hadn't thought it would doom her to hell she would have done something herself.

I have to say I sort of understand where she was coming from. She lived to over a hundred years old. Her husband and children had passed by the time she was 98, all of her friends were dead, she couldn't participate in public (church etc) life in a way she found fulfilling... It honestly seems like a terrible situation to be in.

Live well when you're young and able, the last parts are of little value.

This was basically what I learned from those years. I was in my late teens, and it really shaped the way I lived and what I valued in young adulthood.

You know, I'm contemplating a hip replacement at not quite 40 which can be problematic if it wears out too fast, but there does seem to be a lot of advice these days to do it when you're young for reasons like this. Still far from an easy decision for me though.

In my US state, physician assisted suicide is legal in cases of terminal illnesses. In most states, it is not. I know of a few family friends living elsewhere that have chosen to end things rather than drag things out for months, and bankrupt their spouse..

You have to understand as well, that there’s a lack of God or spirituality that probably reduced the suicide attempts for fear of going to hell or not having an understanding on how to deal with suffering.

It doesn't have to be depression, it could be very rationale. If my mind goes, why would I care how long my body survives after?

People are listing the obvious but missing the correct answer: mental illness causes suicide. The brain goes in old age, which doesn’t just mean cognitive impairment but personality changes, mood and behavior regulation difficulty. Older people may hallucinate, are typically delusional and paranoid, they have trouble controlling themselves including mood and excretory functioning. There are notable examples in the public view right now if you’ve never experienced it. That someone not in control of their own mind might kill themselves is obvious. There needn’t be rational reasons like those listed and I suspect there often aren’t.

I agree. No one can tell me there’s any state of mind they can be in where they want to die by suicide. That is a mildly healthy state. Pain and suffering are no excuse to die by suicide.

People do not know what it means to say “if I was suffering, I would just kill myself“ to someone who lives with the mental illness and his homeless. Because mid 50s and that’s me. So you’re literally giving me the OK to kill myself.

I hope your situation improves. Keep the faith.

Reply on news.ycombinator.com