- the human side of optometry
is on the rise among seniors. Here's how you can help your patients.
BY PAMELA J. MILLER, O.D., F.A.A.O.,
am the survivor of a successful suicide." With these words, Donna told me of her
father's death. We had seen 70-year-old Carl only three months earlier, the victim
of sight-robbing macular degeneration in the last stages. Carl was a retired professional,
widowed for almost five years and still living in their home of 40 years. He had
mentioned to his friends that he would kill himself once he became blind. True to
his promise, Carl ended his life using the gun he kept for protection against intruders.
It's no longer the unthinkable
to a recent article in The Los Angeles Times, suicidal thoughts are common among
the elderly, with someone over the age of 65 committing suicide every 95 minutes. Most commonly, it is an 84-year-old white
male, with men four times more likely than women to kill themselves. Both sexes
often use a gun; access to firearms is associated with increased risk for suicide.
These people are not mentally ill or terminally ill and most have seen their doctors
within the previous month.
This is one of the fastest growing
problems in our country today and is easily treatable, requiring little more than
paying better attention to our older patients' medical care. Almost one fifth of
all suicides are in the elder population, the Times article stated, and this figure
is expected to rise dramatically as we reach an estimated 77 million seniors by
Put yourself in their position
Contrary to some beliefs, depression is not a
normal part of aging. However, our senior population is often faced with failing
health, financial concerns and pressures put upon them and their families. This
is a group that frequently suffers from a lack of social support, loss of friends
or relatives and poor sleep patterns. Very often, this is a patient who is losing
vision, independence and the ability to engage in the activities that he or she
has spent a lifetime enjoying.
Here's where we come in
What can you and I do? First of all, be proactive.
We need to ask our senior patient if he or she is depressed. If the answer is yes,
ask if the patient has contemplated suicide. Some states (like Oregon) and cities
(like San Francisco) have even developed public health campaigns or dedicated 24-hour
help lines for seniors.
Don't be afraid to broach issues such
as loss of friends and family support, loss of vision, financial concerns, etc.
Do your patients feel nervous, empty, worthless, or tired? Are they not enjoying
life like they used to? Are they eating or sleeping more or less than normal? Do
they have persistent headaches, stomachaches, or chronic pain? Perceived poor health,
rather than actual poor health, is often a sign of depression. Let your patients
know that there is help and that you are going to guide them to it. Refer immediately
to the primary care physician for possible medication, as well as a mental health
It is the responsibility of every health
care professional to help our patients, not just with their vision, but with their
quality of life. The senior death wish is preventable and treatable and we can make
a difference in this fast-growing segment of our society.
References available upon request.
DO YOU HAVE A MEMORABLE
EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH RENé
LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC
MANAGEMENT, AT (215) 643-8132 OR LUTHER@LWWVISIONCARE.COM.
OM OFFERS AN HONORARIUM FOR PUBLISHED SUBMISSIONS.
Optometric Management, Issue: February 2006