Loneliness, hopelessness, the feeling of being a burden. And then there’s the pain. When all of this comes together, it can cause elderly people in need of care to lose the will to live.
“I don’t want to anymore” or “I hope I don’t wake up tomorrow.” When a grandmother or father says these things, the situation is very difficult for the family members. They worry that the person they love so much will get hurt. How can you help? Here are some questions and answers on the subject:
How much space do issues such as the end of life and dying occupy among people in need of care and their families?
The finiteness of life itself is a topic that concerns people in need of care. And many of them have no problem expressing questions and thoughts about the topic in front of their loved ones.
This is shown by a recent survey conducted in Germany by the Center for Quality in Care (ZQP) together with the National Suicide Prevention Program (NASPro). For this purpose, 1,000 people over the age of 45 were surveyed, all of whom were considered family caregivers. 85 percent said that the person in need of care had talked to them about dying and death.
About half of the relatives surveyed recalled expressions that indicated a lack of desire to live. The most common were the desire not to wake up (27 percent) and the feeling of being worthless (27 percent). Six percent of the relatives reported that the person they were caring for had expressed the desire to end his or her life.
Why exactly do these thoughts of being fed up with life arise?
It is good to know that when someone expresses tiredness of living, this does not necessarily mean that they are planning to take their own life, that is, commit suicide, says ZQP. However the transition between tiredness of living and suicidal thoughts is often fluid, so family members should be very attentive.
In many cases, depression is behind the desire to stop living. “It is an independent illness and more than just a reaction to living conditions. The symptoms are often misinterpreted,” says psychiatrist Ulrich Hegerl.
Predisposition plays an important role in the development of depression. Those who have already suffered from depression at an earlier stage in their life may experience episodes of the illness again.
Especially if – as in the case of those in need of care at an older age – various factors come together that mitigate the will to live: pain, the feeling of depending on another, but also hopelessness, shame, or conflicts with family members.
How should you react if someone expresses that they are fed up with living?
“It is important to identify the specific causes and what is particularly affecting the person in need of care,” says Ralf Suhr, President of the Centre for Quality in Care. This requires open listening and comprehensive questioning.
When you can see where these dark thoughts are coming from, you can organize appropriate help. Perhaps the possibilities of pain therapy have not yet been exhausted. Perhaps families can develop ideas about how loneliness can be reduced.
According to Hegerl, it is also an important step to clarify with professionals whether depression or some other mental disorder is behind the lack of desire to live. That is, contacting a general practitioner or a psychiatrist, making an appointment, and accompanying the person to the consultation.
These are all things that people with depression can hardly do on their own. “People with depression have a hard time asking for help. Exhaustion, hopelessness, the feeling of being a burden on others – all of these things are part of the illness,” says Hegerl.
How can I detect how serious possible suicidal thoughts are?
Hegerl recommends organizing a conversation in this regard in two parts. The first part is about determining how high the risk of suicide is. And that is all. “That means that one should avoid offering comfort and help,” recommends the psychiatrist.
Instead, family members should ask questions: How long have you been having such dark thoughts? Do you have concrete plans to take your life? Have you ever been close to doing so in your life?
“These are very difficult discussions,” says Hegerl. But they can help relatives get an idea of how serious the situation is. How they can react and help depends on that.
And that will be the second part of the conversation. Then you can suggest arranging an appointment with a doctor. Or say: “I will make sure that you are not alone in the first place.” It is important to remember that when there is a high risk of suicide, you must act immediately.
According to experts, it is important to provide people in need of care with telephone numbers where they can ask for help at any time, for example from relatives or crisis centers.
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