Current topics explained by RUG professionals

Elderly suicide

Three older married couples in the north of the Netherlands committed suicide over a short period of time. Earlier, the Statistics Netherlands agency had announced that the number of suicides among people over sixty had been going up over the past few years. What are we to make of this?
By by Jurgen Tiekstra / Translation by Sarah van Steenderen

Jos de Keyser

Professor by special appointment of psychology and clinical psychologist at GGZ Friesland

For three years, Jos de Keijser worked on a professional guideline for suicide prevention. In spite of this easily accessible help, the number of suicides has not gone down. ‘There are two reasons for this. One: we’ve been in an economic crisis the past five years, and men between the ages of forty and sixty who lose their jobs and become depressed decide to commit suicide relatively often. The second reason the number of suicides has risen is because of the elderly.’
They commit suicide relatively often. De Keijser: ‘There are two sides to this: there is a group of elderly who are done with life and who decide to end their lives. But there are also elderly who get depressed, isolate themselves, and commit suicide. Prevention should be aimed at those people, because they commit suicide because they are depressed.

Why do the elderly commit suicide relatively often? On the one hand, it’s because of our prosperity, says De Keijser. The suicide rate in rich countries, such as the Netherlands or in Scandinavia, is much higher. ‘It has to do with our quality of life. We find it difficult to bear suffering. We’ve got this idea that there has to be a solution for everything. People are in pain, their hips are old and they need a new one. People are increasingly demanding about what should be possible.’

‘And some elderly people don’t know how to cope with it when there isn’t an easy solution. Another, entirely different, reason could be that people over seventy have never learned how to ask for help. This group has always taken care of others, has always worked hard, but has never learned how to take care of themselves. This group has the greatest resistance to mental help with depression.’

Wim van den Heuvel

Retired professor of healthcare

He is not surprised to hear about older people committing suicide, Van den Heuvel says. Take for instance the debate about a ‘complete life’. ‘The Schnabel committee has said that the current law on euthanasia offers sufficient options for people who are having trouble staying alive. Minister Schippers has ignored that advice and instead wants a law for assisted suicide in people over 75 who are done with their lives. That is basically euthanasia for healthy people, when the euthanasia laws have their basis in unbearable suffering.’

‘I agree with the Schnabel committee, because it’s my experience that otherwise it creates societal pressure on the elderly: ‘Don’t you think it’s time for you to go? You’re ninety years old. You may not have any ailments now but never say never. You’re also very expensive.’ The elderly might feel obligated to stop living. It doesn’t surprise that discussions like these being prevalent in society is giving the elderly the idea to commit suicide.’

Another social factor is that care for the elderly has undergone many changes over the past years, due to government cutbacks and decentralisation of municipalities. This can make the elderly feel more vulnerable, Van den Heuvel thinks. ‘I’m basing this on a study I published a few months ago, which shows that between 2000 and 2014, elderly people’s well-being in European countries has decreased. The economic crisis means that care for the elderly has been changed in many countries. I won’t go as far as to say that this has increased the suicide rate, but I’m trying to suggest that this is a reason for the increased uncertainty among the elderly.’

Marian Verkerk

Professor of ethics of care

I get the impression that this is just an awful coincidence’, says Verkerk of the three recent double suicides. ‘I don’t think this is a northern trend. You can attribute the phenomenon to older people feeling left alone, they no longer feel welcome in our society, which then causes them to commit suicide. But that sounds rather far-fetched to me.’

‘It is true that the north, and especially the province, is a slightly harsher place for the elderly: we have fewer facilities, the economy isn’t great. But it’s not just about healthcare, but also about loneliness, social contact, about being able to cope with a changing society. But it’s not a new problem. Saying that this leads to more suicides is a step too far.’

‘The university is greatly focused on healthy ageing; the idea that people should be healthier as they age. That’s about more than just healthcare. It also means creating a living environment where older people’s lives have meaning. I also think that these people shoulder some responsibility for that themselves. They should be prepared for their future.’

‘With this, I am agreeing with Hedy d’Ancona (ed.: former politician and secretary of state) who hasn’t had much support on her opinion. Only a small percentage of the elderly actually lives in nursing homes; more than eighty percent of them live on their own. It kind of concerns that me that we’re saying that we’re having a suicide epidemic.’

‘The elderly have become an object of healthcare. They need to go back to being subjects, and tell us what it’s like to be old, and what they need. I’m getting on in years myself. I hope that I haven’t become an object of care in twenty years.’