Recognizing Passive Suicidal Ideation in Older Adults
Jake Newby
| 4 min read
Key Takeaways
- Certain phrases or expressions could be identified as passive suicidal ideation. They may range in severity and intensity.
- Older adults experiencing thoughts of passive suicidal ideation won’t always express those thoughts, making it difficult for family members to pick up on.
- Many of the risks associated with passive suicidal ideation for older adults are the same for all other age groups, but loss of self-sufficiency and cognitive impairment are other factors that apply to seniors.
- Asking questions, being present, helping older adults connect and following up are some of the ways to support a loved one expressing passive suicidal ideation.
Older adults make up roughly 17%of the United States population, yet they make up approximately 22% of suicides, according to the National Council on Aging (NCOA).
Signs or warnings of a potential suicide may not be easy to read in older adults. Sometimes, they may express passive suicidal ideation, which is defined as thoughts of death without a clear plan or intent to take their own life. Suicidal ideation does not always mean a person is going to attempt or complete suicide, but it should be viewed as a serious warning sign.
Recognizing passive suicidal ideation in the older adults in your life can make a lifesaving difference.
Examples of passive suicidal ideation
It’s important not to disregard certain things older adults say. Certain phrases or expressions could be identified as passive suicidal ideation. They may range in severity and intensity, and include phrases like:
- “Maybe I’ll fall asleep tonight and never wake up.”
- “This world would be better off without me.”
- “My family would be better off if I wasn’t around anymore.”
Older adults experiencing thoughts of passive suicidal ideation won’t always express those thoughts, making it difficult for family members to pick up on. They may wish the world would end tomorrow or have fleeting thoughts of veering their vehicle off the road while driving, to use two other examples.
Risks associated with suicidal ideation
Many of the risks associated with passive suicidal ideation for older adults are the same for all other age groups. They can include:
- Access to lethal means
- Chronic pain or illness
- Depressive symptoms
- Grief encountered following the loss of a loved one
- Sleep disturbances
- Substance use
The NCOA notes that homebound seniors who lose a spouse and are left to live on their own – with no family members or friends nearby – may lack the social connections they need to thrive and thus develop passive thoughts of suicide.
Loss of self-sufficiency and cognitive impairment are other factors that apply to seniors. A 2023 study found passive suicidal ideation to be more frequent among individuals with mild cognitive impairment (MCI). A separate 2021 study found older adults with MCI and dementia had a higher risk of suicide. Declining cognitive function can alter a person’s decision-making abilities, lead to more aggressive behavior and increase impulsivity, according to research.
Finally, financial troubles could lead to suicidal thoughts for older adults, according to the NCOA. Those living on a fixed income may struggle to pay their bills.
When these issues compound, feelings of depression can sometimes evolve into clinical depression, which is not a normal part of aging. It’s a condition that is under-recognized, under-diagnosed and under-treated.
Recognizing the warning signs of suicide in older adults
Passive suicidal ideation can escalate into suicide warning signs if older adults exhibit any of the following behaviors.
- Looking for a way to kill oneself
- Talking about wanting to die
- Losing interest in activities they once enjoyed
- Changing their will
- Giving away beloved items
- Avoiding social activities and isolating
- Avoiding or neglecting to see their doctor or undergo medical regimens
- Neglecting self-care and grooming
- Having a preoccupation with death
- Lacking concern for personal safety
- Talking about being a burden to others
- Sleeping too little or too much
- Displaying extreme mood swings
How to support a loved one with suicidal ideation
If you get the sense an older adult in your life is struggling with suicidal ideation that could progress into something more serious, try to be there for them as much as you can. The 988 Suicide & Crisis Lifeline outlines five action steps individuals can take if they know an older adult who is thinking about suicide.
Ask questions like, “are you thinking about suicide?” and “how can I help you?” to initiate a conversation in a supportive, unbiased way. Listen carefully to their answers and acknowledge their pain. Help the person stay focused on all the reasons why they should want to keep living.
Be there. If you can, try to be physically present to ease feelings of isolation and provide a sense of connectedness.
Keep them safe by finding out if the person has already made any attempts to die by suicide. Do they have a specific plan or timing in mind? Do they have access to their planned method of self-harm? These answers aren’t always easy to get, but if you can understand whether an individual is in immediate danger, you can proceed to figuring out next steps.
Help them connect. If a senior in your life is thinking about suicide, it’s important to establish support systems they can rely on, both now and in future moments of crisis. This includes suicide prevention helplines such as the 988 lines, support from a counselor or mental health professional, as well as other resources available in their local community.
Follow up. Studies have shown that following up can reduce suicide-related deaths in high-risk populations. Once you've had an initial conversation with the vulnerable person and helped them establish a support network, make sure to check in.
In addition to calling or texting 988, individuals can seek urgent, immediate supporting their community by contacting a Michigan crisis resource facility near them.
Photo credit: Getty Images
