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By Rose Hoban
Alan Reid has a few places that he goes regularly. Reid, a retired computer systems analyst, moved from the Atlanta area to Pittsboro a few years ago after his wife died to be close to his sister and his son who both live nearby.
“It seems like there’s always something to do, my sister’s always needing something fixed, or whatever,” Reid said.
On Wednesday mornings, he goes to a woodturning class at the community college, after class, he heads to lunch with his classmates. And on Thursdays, he hangs out with other retired men at the senior center in Pittsboro for the “Geezers, Gulpers and Gardeners” group.
“I see this as a chance to get out of the house some and meet some people and socialize,” Reid said.
You could say that Reid is “doing” retirement successfully: staying connected, keeping engaged and involved, and learning new things. All those tasks are important for keeping isolation and depression at bay, something that becomes an issue, in particular for older white men.
It’s important for that demographic, in particular, because recently published statistics show rates of suicide begin to rise after 65, especially in white men.
In fact, white men 65 and older have the highest rates of suicide in the population, according to an issue brief published by the North Carolina Injury and Violence Prevention Branch of the state Department of Health and Human Services.
The numbers show men over the age of 85 have the highest rate of all.
“We’ve known for a long time that older adults, specifically older white males are at the highest risk for suicide,” said Mary Lynn Pivin, a psychiatric nurse practitioner and researcher from the UNC School of Nursing. “However, getting that information out into the public and having other professionals respond to that knowledge is very challenging.”
Between 2010 and 2014, 1,057 seniors in North Carolina committed suicide. Of those deaths, 83 percent were males and 94 percent of all senior suicides were white.
Pivin said that rather than being the “golden years,” aging is often filled with losses big and small.
“Losing friends, medical illnesses like cancer, arthritis, heart disease, they can’t be as physically able as they were,” she said. “Some of the changes people are experiencing could be seen as unacceptable.”
They guys in the 3G group nodded in agreement when that idea was brought up. George Lee, one of the 3G members, said he had planned on setting up a little machine shop in his garage. But as he got near retirement, arthritis made the work difficult.
“I found out I couldn’t lift and do what I used to do,” he said.
Instead, Lee keeps himself busy by working as a receptionist at the Pittsboro senior center two days a week. He’s driven for Meals on Wheels, worked checkout at Dollar General and volunteered. He works about 24 hours each week.
“You need to fill in the time with something or else the boredom comes in when it gets long,” he said. “You just have to keep finding some hobby or reading a book or something, go fishing.”
A few years ago, Lee’s wife died. ”It were lonely, so I just kept moving,” he said. Eventually, he remarried.
Harry Richardson said after a career as an accountant and auditor for various governmental agencies, he had a challenging transition to being retired.
“That was my identity,” he said. “But now, other than just being Harry that’s married to Wanda, I don’t know that I have an identity… as stupid as that might sound.”
Richardson is onto something.
Pivin said that once their professional identities are gone, men can become “downcast by the thought of the future, by the reality of the present that they feel like they can’t control anything anymore, or they’re not in charge of their life.”
Those left behind
The older adult population is growing quickly in North Carolina.
“In 2015, 15 percent of the population was 65 or older, and that number is expected to increase to almost 20 percent in 2025 based on North Carolina population projections,” wrote Shana Geary who compiled the suicide numbers for DHHS.
“Our data show that rates of suicide among adults 65 and older were 10 times higher than North Carolina youth,” she said. “Despite making up a significant proportion of the population, the older adults are often overlooked, particularly when it comes to suicide.”
It’s hard to know exactly what compels some older men to contemplate the act. According to the statistics, 81 percent of senior suicides were accomplished using a firearm, which is almost always fatal. Only about a quarter of men left notes or explanations of their actions, close to half of women did, but their total numbers were few. So, any explanation has to be teased out by interviews with surviving family members and friends.
There are other differences between men and women. For instance, 62 percent of women who committed suicide were characterized as having a current mental health problem, whereas that only applied to 42 percent of men.
Pivin said that depression is often a factor, even if families, friends or healthcare providers don’t realize it.
“You can send yourself into a depressive tailspin if you’re not careful,” said Richardson, who said he comes to the 3G group to have some conversation with other men. “But you can’t allow yourself to do that.”
People who had a history of depression when they were younger are at higher risk, but depression can look different than when they were younger. Pivin said medical professionals often overlook the signs in seniors, which can take the form of more complaints about aches and pains, weight or appetite loss, loss of interest in hobbies or socializing, or low energy.
“Even though we’ve had validated [screening] tools for years, they’re only now beginning to be incorporated into routine hospital admissions, social service admission evaluations and they’re not done uniformly,” she said.
Pivin also noted that some of the medications that older people are on can cause depression, such as prednisone, for breathing problems, and even cancer chemotherapy drugs.
”But we don’t teach patients that,” she said.
Urban vs. rural
Another set of statistics released recently showed that people in rural counties are about two times more likely to commit suicide. National data from the Centers for Disease Control and Prevention found that over the entire country, suicide rates increased from 1999 through 2015, but the rates increased faster in more rural counties, with the most rural counties experiencing the steepest increase.
Senior center director Dennis Streets initiated the 3G group before the CDC data came out, but he said that one of the goals is to alleviate some of the isolation of rural living.[sponsor]
“Maybe they’re no longer able to drive, they’re having some problems with ambulation, maybe their vision is not as good,” he said. “They can get isolated and neglected and in some sense doubting their own self-worth.”
Pivin called Streets “brave” for starting a group to serve a rural population, where “there is so much bias and lack of belief that there is even such a thing as mental illness.”
“There are people who won’t even speak or acknowledge depression,” she said, particularly in more traditional rural areas where she’s from.
Pivin also noted the stronger influence of religion in rural areas, and how those belief systems forbid taking one’s own life.
The CDC also noted the lack of mental health providers in rural areas, the difficulty of conducting prevention activities in such areas, and the need to use different prevention strategies than in urban areas.
Pivin echoed that, noting that in North Carolina’s local public health and social service agencies where seniors could be screened, staff has been “cut to the bone.”
“There’s often not time to spend assessing someone for depression,” she said.
Mary Lynn Pivin helped to devise Healthy IDEAS for Seniors, a depression management program. The program is cited as an evidence-based intervention by the National Council on Aging.