Explanation

Older adults represent a particularly high-risk population for suicide. Despite having lower rates of suicidal ideation compared to younger populations, older adults have disproportionately high suicide completion rates. They are more likely to use lethal means, less likely to communicate intent, and more likely to die on the first attempt. Passive suicidal ideation, declining self-care, and statements like 'tired of living' should never be dismissed as normal aging. These presentations often reflect undertreated depression, demoralization from chronic illness, unaddressed pain, social isolation, or loss of meaning and purpose. The PMHNP should conduct a comprehensive assessment that includes evaluation for treatable depression, optimization of chronic illness management in coordination with other providers, exploration of the patient's values and sources of meaning, assessment of social support and isolation, and development of a safety plan with ongoing monitoring.

Key Takeaway

In older adults, passive suicidal ideation, chronic illness, and undertreated depression can coexist. Older adults have disproportionately high suicide completion rates.