he better hurry as suicides by older folks are on the rise:
May 20, 2007
Suicides by older folk on the rise again
Quiet upswing (cos censored by the 154th mah!) after dramatic decline (cos of creative accounting mah aka "unnatural death") between 1995 and 2002 worries experts
By Radha Basu
PHOTO: WANG HUI FEN
COOPED up alone in his one-room flat, nearly blinded by diabetes, 57-year-old Chiew Han Sai led a bleak and lonely life. At 2am on Oct 18 last year, he jumped from his seventh-floor Toa Payoh flat. He died instantly.
Diabetes had also taken a toll on retiree Andrew Cheng (not his real name), 92. In April last year, shortly after doctors told the Tampines resident they would have to amputate his gangrenous leg, he too jumped to end his life.
Housewife Tan Ah Moy, (not her real name), 67, from Jurong was plagued by demons of a different kind - she thought someone was going to kill her. A fortnight ago, the mother of two was found dead at the foot of her block. Investigations are on. But suicide, once more, is the likely cause.
The number of older folk killing themselves is creeping up again, after a dramatic, much-chronicled decline between 1995 and 2002.
Last year, 133 people aged 55 and above killed themselves, figures from the Registry of Births and Deaths show. That's a 50 per cent increase from the 90 deaths recorded in 2002.
Suicides are likely to rise as the population increases. Indeed, the 419 deaths recorded for all age groups last year is the highest in recent years.
But what is worrying is that suicide rates per every 100,000 older folk - which would take into account any fluctuations in population - are also on the upswing.
In those aged 55 and above, they rose from 17.3 in 2002 to 20.5 last year.
And though this is nowhere near the all-time high of 32.1 recorded in 1995 - when suicide rates among older folk here were among the highest worldwide - some experts say the time has come to sound warning bells.
Gerontological counsellor Helen Ko and Professor Kua Ee Heok - both experts in the psychology of ageing - say the upswing could have been because after the dramatic decline in rates around the turn of the century, authorities and experts had taken their 'eyes off the ball'.
When suicide rates among older folk peaked in the mid-1990s, many new programmes targeted at them were introduced, says Prof Kua, who heads the National University of Singapore's Department of Psychological Medicine.
These included new daycare centres, hotlines and home-help services for older folk, says Prof Kua, who also tracked elderly suicides in the past decade.
In 1999, a special inter-agency workgroup tasked to devise suicide-prevention programmes targeted at the elderly was also set up.
Chaired by Mrs Ko, the Golden Life Workgroup comprised members from about 20 organisations, including hospitals, voluntary welfare bodies and the police.
It conducted workshops educating family members and professionals such as nurses and social workers on how to spot warning signs in those who harboured thoughts of killing themselves.
Once the rates came down by 2002, elderly suicide prevention 'stopped being a priority' and the group began looking at elder abuse, says Mrs Ko.
For the past two years, the Institute of Mental Health, however, has been holding its own workshops to train professional caregivers on how to spot and deal with elderly suicide. No such regular workshops are currently held for family members.
Since early last year, IMH has also started a home visit for frail old folk who prefer to be treated at home. But these visits are targeted only at those above 65.
With the numbers creeping up again, attention will need to be diverted back to older folk once more, say experts.
Pain, loneliness, depression and financial problems are all factors that cause the elderly to end their lives.
Those between 55 and 65, in particular, could need attention, says Mrs Ko, now a principal consultant with the Centre for Seniors.
Indeed, last year at least, 81 of the 133 older people who killed themselves were in this age group.
'Most elderly suicide prevention programmes focus on those above 65,' says Mrs Ko.
'Those in their late 50s and early 60s who are grappling with retrenchment or retirement could need help just as much.'
An average of about 65 people above 65 have been killing themselves here yearly, though last year the figure was lower.
The growing tribe of elderly singles who live alone is another 'high risk' group, says senior assistant director Tan Yoke Yin of suicide-prevention group Samaritans of Singapore.
Social workers say that providing psycho-social help within the community is just as important.
Both Mr Chiew and Madam Tan, for instance, had been released from the Institute of Mental Health less than a month before they killed themselves.
Mr Chiew lived alone. He owed several months of utilities bills, says a social worker familiar with the case.
'If he had stopped taking his medication, there is no way anyone would have ever known,' she says.
Not all experts, however, are concerned about the rising suicide numbers. Scrutinising such figures year-on-year is misleading, says psychiatrist Chia Boon Hock, who has been studying suicides here since 1970.
'With small numbers in a small place like Singapore, it would be normal for rates to fluctuate very widely,' he says.
Trends could therefore be established only by studying suicide rates over decades.
'Seen over decades, suicide rates among the elderly are coming down in general,' he says.
But Prof Kua disagrees, saying that keeping a close watch on numbers could lead to more timely support programmes.
More programmes to train general physicians to be aware of the danger signs is imperative, says the former IMH chief executive officer.
'We must never forget that suicide is always preventable.'
Families who have lost loved ones could not agree more.
A young woman whose 63-year-old mother jumped to her death last year says she wished there were more suicide awareness programmes teaching families how to spot the 'warning signs'.
Her mother was depressed for months and spoke of killing herself occasionally. During her last days, however, her mood seemed to have improved considerably.
Sudden mood changes - even for the better - say experts, could be a sign that the victim had already decided to commit suicide.
'The signs were there, we simply did not know how to spot them,' the young woman says.
'And the world collapsed on us.'
(The names of some suicide victims have been changed to protect their identities.)
