All pets go to heaven.

— She helps them do it at home.

Eden Gaines, left, talks with veterinarian Karen Meyers about the decision to euthanize Xochitl, a boxer-Great Dane mix who has cancer.

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Veterinarian Karen Meyers pulls her black minivan into the driveway of a townhouse in Maryland’s National Harbor. The home, in a gated community, is perched on a windy bluff not far from restaurants, bars, a casino — places of revelry.

The vet carries her brown doctor’s bag inside. There, she meets her patient: Xochitl, known as Xochi, an 11-year-old boxer-Great Dane mix weighing around 80 pounds.

Xochi, recently diagnosed with cancer, is struggling. A film covers her right eye. She had been bleeding from her mouth, refusing to eat. Now she stands in the townhouse’s living room, mournfully greeting family members who have come to say goodbye.

Xochi climbs onto the living room’s leather couch and lies down. Owner Eden Gaines and her family gather around her. Meyers opens her bag.

Meyers explains the procedure. First, Xochi will be injected with a sedative to make her fall asleep. Five to 10 minutes later, Meyers will administer sodium pentobarbital, which will euthanize her. But Xochi would feel no pain, Meyers assures the family.

She asks whether anyone has any questions.

No one does.

“Here we go,” she says.

Meyers says she has euthanized 1,500 animals in four years.

Pet adoption spiked during the pandemic, with nearly 1 in 5 American households taking animals in and spending far more on them than pet owners did decades ago. With more beasts in our lives — as companions, as emotional support animals, as the beneficiaries of pet trusts — it only makes sense that their owners want their final moments in their lives to be as peaceful and painless as possible.

That’s where Meyers comes in. Working with Lap of Love, a company that provides veterinarian referrals for at-home pet euthanasia, she travels from house to house in the D.C. region offering grieving families’ animals what the word euthanasia means: “good death.” In four years, she has euthanized 1,500 animals: cats, dogs, rabbits, rats. Some had been with their owners since childhood. Some had traveled the world with them. Some were their owner’s sole companion.

Meyers has observed death rituals that include praying, burning incense, wrapping a deceased pet’s body in a white sheet, and opening a window for a pet’s spirit to exit. She has listened to owners read poems or letters to their pets and cried along with them.

“When people hear what I do for living, it sounds sad,” Meyers says. “But it’s strangely rewarding. … You give pets a peaceful experience. It’s a final gift.”< Meyers has been surrounded by a menagerie all her life. Growing up, she usually had a dog and one or two cats; at various times, she’s also had two hamsters, two turtles, a guinea pig, a bird and four chickens. Right now, she has Wren, a 6-year-old Cavalier King Charles spaniel; Travis, a 3-year-old pug; Brinkley, a 13-year-old rat terrier Chihuahua; and Pablo, a red-belly parrot. Right before the pandemic, Meyers decided to shift to doing euthanasia full time. She had been a veterinarian for more than two decades, and pet euthanasia turned out to be less stressful than working in an office while raising two children. In-home euthanasia can be easier on animals and their owners than office appointments with other sick animals and their distressed owners crowded around.

The first injection makes Xochi fall asleep.
Rameses Gaines holds a piece of Xochi’s fur.

Meyers administers the first shot in Xochi’s back. The dog, already lying down with her head on Gaines’s lap, turns to glance at Meyers as if mildly annoyed.

Then, the dog relaxes.

Minutes pass.

Using a hair clipper, Meyers shaves an inch-long strip of one of Xochi’s legs and inserts a small IV line. After confirming that the family wants to continue, Meyers administers the second shot, the one with the fatal dose.

Gaines looks at the spot on Xochi’s leg where the IV had been inserted.

“It’s amazing how gray she became,” Gaines says.

Meyers holds a stethoscope to Xochi’s chest. “Xochi has her wings,” she says.

The family cries.

So does Meyers.

She and Gaines embrace.

Meyers maneuvers Xochi onto a stretcher and covers her with a blanket. With the help of Gaines’s sons, she loads the dog into her car. Eventually Xochi will be cremated and her ashes returned to the Gaines family.

Death is a part of life, Meyers says.

“Many times, people will comment how a human family member passed, and it was so painful at the end, and this is peaceful by contrast,” she says.

They tell her, she says, that they wish they could go the same way.

Rameses Gaines touches a mold of Xochi’s paw print.

Complete Article HERE!

Asian Elephants display complex mourning rituals similar to humans

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Elephants are smart animals with strong feelings and they often work together. In India’s Bengal area, scientists found that elephants buried five baby elephants, according to a study published in the Journal of Threatened Taxa.

Researchers have limited the study of elephant thanatology—the examination of death and related practices— to the burial of calves. Observers had noted this aspect of behaviour in African elephants but had not documented something similar in Asian elephants until recently, despite both species diverging 4.2 million years ago.

The researchers wanted to clear up the second question – do Asian elephants, like African elephants, mourn their dead calves? And the answer is yes, and it is loud. The vocalizations from the elephants lasted between 30 and 40 minutes, but only in places far from human settlements.

They point out that this behaviour suggests elephants distinguish human spaces from non-human spaces to avoid disagreements. They also mention that elephants limited vocalisation to the burial phase.

The increasing encroachment of human activities into natural habitats and the resulting environmental degradation are forcing elephants to venture into human-dominated areas in search of food and other ecological necessities. This interaction has led to new behaviours in these majestic creatures.

Asian Elephants’ mourning behaviour

Parveen Kaswan, an officer with the Indian Forest Service, and Akashdeep Roy, a researcher at the Indian Institute of Science Education and Research, spent 16 months reviewing literature relating to elephant burials. They found five case reports that document this behaviour.

An elephant calf was buried on a tea estate with its feet visible.

Researchers have revealed that Asian elephants, similar to their African counterparts, engage in what we can describe as mourning rituals. Observations showed them vocalising loudly and burying their deceased calves, exhibiting a level of ritualistic behaviour that parallels human funeral rites.

The study reports a heartbreaking journey of a mother elephant. The mother elephant carried her dead calf for two days before letting it go. This extended time of grieving shows the deep attachment between mother elephants and their offspring. This could have been made stronger possibly by hormonal influences like oxytocin and the long gestation period elephants experience. This response is consistent with other studies on chacma baboons, olive baboons, African elephants and Thornicroft’s giraffes.

As per the study, the burial process is a collective effort, involving not only the mothers but also other females within the herd who act as surrogate caregivers, as well as elephants of various ages. This communal participation underscores the intricate social fabric of elephant herds and their collective mourning when faced with death. Notably, this ritualistic burial is reserved exclusively for the young. The physical impracticality of carrying the larger, heavier adults precludes them from receiving the same rite. This selective practice indicates that the elephants’ mourning and burial customs are particularly significant for the young, whose passing deeply impacts the social structure of the herd.

Compassionate behaviour

The research aimed to understand the ‘perimortem’ strategy and ‘postmortem’ behaviour of Asian elephants. The main evidence shows that someone or something transported the corpses from afar, treated with great care. They buried the corpses in preferred locations, always in a specific posture, which was an unusual lying position with legs upright.

The author said, “Our study found an interesting thing – the placement of carcasses with their paws raised in narrow irrigation drains. This strategic behaviour shows the care and affection of herd members toward the deceased animal and suggests that in a potential crush situation, pack members prioritize the head over the feet,” they highlight.”

“Elephants are social and affectionate animals and, based on an external examination of the carcasses, we also suggest that herd members gently placed the dead calves by grasping one or more legs,” the experts conclude.

The authors of the report thoroughly investigated the underlying reason for the death of the offspring through postmortem examinations. One of the conclusions is that there was no direct human intervention in any of the five deaths.

A buried carcass corresponding to case 3 of Bharnabaritea estate.

“Through direct and indirect evidence, this study highlights compassionate and helpful elephants’s behaviour during carcass burial. Asian elephants transport their deceased calves to isolated places, away from humans and carnivores, while searching for drains irrigation and depressions to bury the body,” the report states.

No infanticide among Asian elephants

Many animal groups, such as monkeys, meat-eaters, and rodents, commit infanticide or baby killing. Different reasons, such as elimination of competition, scarcity of resources, or maintaining social order within a group, contribute to this phenomenon.

However, the researchers found that there was no infanticide among the Asian elephants. They believe there are a few reasons why elephants don’t kill babies:

  • Elephants, particularly females and their young, live in close family groups forming strong bonds. This closeness possibly prevents them from hurting the young, actively encouraging them to cooperate in caring for them.
  • Baby elephants require long term care from their mothers and other females in the herd. This extended care and help from everyone might decrease the likelihood of someone killing a baby.
A buried carcass corresponding to case 2 of Chunabhatitea estate.
  • In the breeding process, elephants reproduce without having to kill their babies to quicken the mother’s readiness for another offspring. Unlike some other animals, the mother cannot immediately have another offspring if she loses a baby. Thereby, eradicating the need for males to kill babies.
  • Male elephants neither directly contribute to raising the babies nor participate in the close female groups. They prioritize finding females ready to mate rather than assuming control over a herd and eliminating other males’ babies. This social structure and breeding style decreases the likelihood of elephants killing babies.

Complete Article HERE!

Irish committee to recommend laws for assisted dying

— Proposed legislation would allow people help with ending their lives under certain medical conditions

The legislation would require two doctors to sign off on a person’s incurable and life-threatening condition.

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An all-party parliamentary committee in Ireland is to recommend that legislation be introduced to allow for assisted dying if a person has a terminal illness or has only a short time to live.

A majority on the Oireachtas committee on assisted dying supported the proposal that the law be changed to allow someone to get assistance to end their life if they have between six and 12 months to live.

The legislation would apply to people who have been diagnosed with an illness or a medical condition that is “incurable, irreversible, progressive” and at an advanced stage that will cause death within six months.

It is expected that the time limit for those with a neurodegenerative condition would be extended to 12 months.

The committee’s report is to be published on 20 March but has now been agreed by a majority of representatives from all sides of the Irish parliament. After its publication it will go to government for further consideration.

It is unclear whether the three-party coalition government led by Leo Varadkar is prepared to introduce legislation to enact the recommendation before a general election expected this autumn.

If it does, Ireland will join other countries including Switzerland, Belgium, Canada and the Netherlands in allowing assisted dying under certain circumstances.

It is understood that the proposed Irish legislation would require two doctors to sign off on a person’s incurable and life-threatening condition.

At hearings representatives of the Christian churches and a Muslim cleric voiced their opposition to the legislation, saying it was morally wrong to kill someone and was against God’s will.

Some psychiatrists also argued it could lead to “a slippery slope” with increasing numbers seeking to end their lives.

But the committee’s recommendation has been welcomed by the chair of the advocacy group End of Life Ireland.

Janie Lazar said: “We’ve been working hard to get people talking about assisted dying and about the choices that should be available to those who have no time to wait or waste.”

Constitutional law experts say they are confident that the committee’s recommendation would not require a referendum but a simple law change.

Nathan Stilwell, assisted dying campaigner for Humanists UK, welcomed the “bold move”, comparing it favourably with the debate in Britain where a report by MPs last month did not recommend a vote on the issue.

“Well done to the Irish special Oireachtas committee on assisted dying for taking an evidence-based and compassionate approach. It’s brilliant to see such a bold move after just a week ago a Westminster committee did not vote for any change in the law,” said Stilwell.

Complete Article HERE!

Death doulas

— Helping people at the end of their life

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You may have heard of a birth doula – someone who provides non-medical support and advocacy throughout pregnancy, birth and after the baby has been born. More recently, so-called death doulas – people who assist at the other end of the lifespan – have been growing in popularity.

The role of death doulas is still relatively new, so the terminology and definitions of what they are based on what they do are in flux. They are sometimes referred to as an end-of-life doula, soul midwife, death coach, dying guide, death midwife and palliative care doula. The actual term used is often down to the preference of the practitioner and how they define their work, as well as cultural norms within the country they work in.

Death doulas are known to work in Brazil, Canada, the Czech Republic, Germany, Ireland, Italy, Japan, New Zealand, Russia, the UK and the US. They tend to provide support to people with life-limiting or terminal illnesses, focusing on improving both the quality of life and the quality of death someone experiences. This can include helping with funeral plans, talking about the processes involved around death, or helping someone with their care appointments.

Sometimes, the doula’s contribution is simply about being next to the person and providing company.

The work of a death doula can extend beyond the dying person. They can provide emotional and social support to family, friends and even neighbours – typically the informal carers and social network surrounding the dying person.

Doulas help those close to the dying person with the impending loss (so-called anticipatory grief). Some also carry out errands and chores to enable them to spend time with the dying person. They may also continue to visit those people after the death to support them as they grieve. Crucially, death doulas can enhance the links between professionals and the social support around a person by helping with communications and advocacy work.

Filling the gap

With healthcare systems and informal carers typically stretched beyond capacity, death doulas can provide a means to fill the gap and provide personalised attention. Someone can access doula support either privately or, depending on the doula, through voluntary means.

My colleagues and I recently examined how end-of-life doulas can be provided by the NHS. It noted that the flexibility of the services doulas can provide was not only helpful for the dying person but also for the wider healthcare system. It helped people who may otherwise not receive support due to service gaps, strict referral criteria, or lack of social support.

Beyond supporting individuals, some death doulas see community engagement as core to their role. They are keen to share information about the dying process and grief with others. They may host workshops or death cafes. Across this work, their contributions are to normalise talking about death, dying and loss in society.

Anyone can become a death doula, and it is not currently a regulated profession. There is a wide range of doula training available internationally, including online, provided either by individual doulas or by organisations such as Living Well Dying Well.

People at a death cafe
Death cafes give people the space to talk about the ultimate taboo.

Personal experience

In addition to their doula training, doulas bring their own professional and personal experience to the role. International research on death doulas has noted that many who have become death doulas have a background in professional healthcare, social care or education, and may already have some experience with death.

Those who have trained to be a death doula can be eligible to join a community of practice. Within the UK, End of Life Doula UK is a membership organisation for doulas, setting standards for doula practice and representing doulas. Similar organisations exist globally, including the International End of Life Doula Association.

Death doulas are not a replacement for specialist palliative care and cannot prescribe drugs. Their role is to support people in having a good death.

The growing demand for death doulas is one example of how society is questioning what a good death can be and how to make it happen. Other examples include discussions about assisted dying and improving death literacy. Rather than consider death a societal taboo, there is a growing recognition that people want to value the end of life and reshape how it is experienced.

Death doulas can play a pivotal role in supporting a dying person and those around them. Their support can be emotional and practical, often bridging the gaps in existing support or helping to signpost to relevant services. Not everyone may want a doula, but those who do may see it as someone who can guide them through a significant life process.

Complete Article HERE!

Why I imagined my husband’s death

— What if fiction can alter the real world?

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In my new novel, A Book of Days, a husband is dying slowly. While I was writing it, my own husband died suddenly, with no warning. He died in his sleep, I was told. His children and I hope that is true. He was 400 miles away, and on his own when it happened. The thought of his loneliness, if he was conscious and aware of what was coming, is unbearable, so we do not think of it. Or we try not to. We do know that he was in bed and his window was wide open; before he could hear nothing more, he would have heard the sea breaking on the rocky shore just below the cottage.

Ever since, I’ve been thinking about the lived experience of death. I don’t mean the first-hand testimonies of people who have actually died. If Lazarus told his sisters what it was like to be dead, they did not record it. If Jesus ever described the loneliness of the tomb, his words have been forgotten. No, I mean death as experienced by the living, the survivors.

The experience of death was once far more widely shared. Two hundred years ago, around 15% of babies in Britain died before their first birthdays. “Death borders upon our birth and our cradle stands in the grave”, said a 17th-century bishop of Exeter. Childbirth was dangerous for mothers too. And back then, most people in this country died in their own beds at home, with their families watching. If they did not, if they died on Flanders Fields for instance, their deaths were still not private in the main. But now many people reach adulthood without ever seeing a corpse.

I have seen several corpses, but I did not see the dead body of my husband. For complicated reasons to do with autopsies, transport and distance, neither I nor our children saw him until he was in a sealed coffin in the back of a hearse. I put my hand on his coffin as we filed past it on our way out of the crematorium, but I wish now that I had asked for it to be unsealed. Or that we had gone to the mortuary where he was. If you don’t see that the one you loved is really dead, how can you believe it?

My main feelings when he died were disbelief and a stony sort of shock that left me dry-eyed and clear-headed. And then there were weeks and weeks of paperwork and practicalities that left no space at all to think about my unfinished novel. There was only the haunting fear that by writing a death I had brought a real one into existence. My rational self knew that was not true. Fictions are not premonitions, any more than dreams are. But still.

“There was only the haunting fear that by writing a death I had brought a real one into existence.”

Even when life returned to something close to normal, I could not write the novel. For a while, I thought about writing a memoir instead, a painfully truthful one, about my husband, my grief and anger, and how complicated mourning is. Truth seemed somehow more relevant than fiction; I kept remembering something novelist Rachel Cusk said in an interview: “Once you have suffered sufficiently, the idea of making up John and Jane and having them do things together seems utterly ridiculous.” I made a start on the unvarnished work I had in mind and then abandoned it almost at once. I knew then that I had had more than enough of me.

If I had written and published that memoir, I would have been asking you, the reader, to sympathise with me. Even, perhaps, to identify with my lived experience of grief. Why should you want to do that? My experience is particular but not in any way unique. If, on the other hand, I could write imaginatively enough to transcend the limits of that experience, to widen it, to bring to it the resonances of other lives, other ways of seeing — well, that I felt would be worth doing. I, as the author, would be opening windows for the reader, not beckoning them to follow me into a shuttered room.

Autofiction — fictionalised autobiography that dispenses with the traditional elements of the novel such as character and plot — is arguably the prevailing literary mode of our time. It suits the general demand for self-revelation in life as well as art: in print, on screens, in public, people share the most intimate of details and bare their souls — or seem to. For years, aspiring writers of fiction have been told to “write what you know”, to stick to their own experience and their own boundaries, and by writing their own lives in thin disguise they are demonstrating their obedience to the rule. This is in many ways a good thing. Care must be taken not to trespass clumsily on territories of gender, racial identity, or sexual orientation. But there’s a difference between unacceptable cultural appropriation and creative imagination. That difference can be described as empathy.

However carefully curated, whatever balance it strikes between “truth” and “story”, auto-fiction requires ego. It says: look at me, even though what you see may actually be a mask. And it implicitly assumes a degree of mutual recognition between writer and reader. It’s a mirror, not a clear window. This can often be immensely valuable. But how, then, can a reader step outside their own personal experience, to feel as Keats felt when he first read Homer: “like some watcher of the skies / When a new planet swims into his ken”, breathless with anticipation like Cortez’s men, “silent, upon a peak in Darien”? How, indeed, unless writers can still write of lives beyond their own known and confined realities?

Great writers don’t need lived experience to convey emotion. The psychologist Steven Pinker described an experiment in which people listened to an interview with a heroin addict, who was either a real person or an actor. When the listeners were asked to take the addict’s point of view, they became more sympathetic to addicts in general, even when they knew the interviewee was acting. In other words, they did not need to believe the “addict” was sharing a lived experience in order to empathise. We can see this in William Golding’s astonishing novel, The Inheritors, which takes us into the world of the last Neanderthals and shows us how it feels to be on the wrong side of the cusp of change: disempowered, under threat and fearful. He achieved this masterpiece through an empathetic leap across millennia that owes everything to his brilliance as a writer and his understanding of unchanging human nature, but little to his own experience of life in 20th-century England.

As T.S. Eliot said: “What every poet starts from is his own emotions [but then transmutes] his personal and private agonies into something rich and strange, something universal and impersonal.” To me, that’s a counsel of perfection, the highest of aspirations. My husband’s death caused me great grief, but when eventually I could write that grief upon the page, through voices that were those of imagined people who lived centuries ago, I hope I turned it into something shared, something that could strike chords in hearts other than my own.

Complete Article HERE!

Speaking of death

— Christians have an opportunity to eschew euphemisms and talk honestly about mortality.

By Rachel Mann

When my father died a couple of years ago, my family asked me to take the lead in organizing his funeral. I was happy to take this role: I am an experienced cleric used to working with funeral directors, and I have a strong understanding of the funeral process. What I’d never previously experienced—at least not from the point of view of a grieving person—is how readily those involved in the ministrations around a death speak in euphemisms. Perhaps it was a token of my grief, but I was annoyed by how many people couldn’t even say that my dad had died; most people, including the funeral director, said, repeatedly, that he’d “passed.”

Does it matter? At one level, no. The phrase “passed away” has been used to refer to death for 500 years. Still, it troubles me theologically. I fear that the prevalence of using passed as a way of speaking (or not speaking) of death indicates a society frightened by the finality of death, one that has opted for an overly spiritualized response to the last enemy.

A common refrain in my clergy circles is about how, on visits to plan funeral services with the bereaved, the only person prepared to use the “D” word is the priest herself. The bereaved will typically resort to any number of euphemisms to avoid it. This is entirely understandable. Shock is a natural reaction to death and, as creatures of language, we may be inclined to retreat to clichés that seem to soften the blow.

Indeed, at one level, euphemisms are entirely comprehensible as strategies to avoid the things we struggle with most. As Voltaire noted, “One great use of words is to hide our thoughts.” This applies to any difficult aspect of life, not simply death. Terms like downsizing and rationalization have been used for decades in business settings to avoid speaking directly about job cuts. In almost every area of life that really matters or troubles us—from sex through to war—there are forms of words that have been found to smooth out what’s difficult.

If death is the greatest human fear, it is hardly surprising that most of us will find ways of avoiding talking about it. The sheer number of ways humans have of avoiding the “D” word is both a testament to our creativity and an indication of how much we fear death.

Yet I think one of the imperatives on us as Christians is to be as honest as we can about death. Priests in particular are called to help people to pray and prepare them for death. Ironically, in an age when Christians are often parodied as delusional fantasists, we in fact have something powerful to offer as people who model realism and honesty about death. And one way we do that is by avoiding euphemisms at the point of death. If euphemisms are deployed in part to soften the nature of something shocking and appalling, ironically they serve to draw greater attention to that which they are meant to conceal. By being carefully and humanely honest about the singular finality of death, both priests and laypeople may be key agents in helping the bereaved to come to terms with the simple fact that, in this life at least, their loved ones are gone.

I am not suggesting that Christians should be crass. I trust we will always be sensitive to death’s ability to strip any of us of our certainties. But the quiet acknowledgment of the final nature of death may be significant both pastorally and for mission. In being clear that death has a shocking finality about it, Christians—as people who are committed to resurrection and new life—may be better placed to speak the good news of Christ. One thing we should not be afraid of in our faith tradition is the bleak reality that God incarnate, Jesus Christ, actually died and died horribly. He did not fall asleep or pass over or, to quote George Eliot, “join the choir invisible.” He died, in a vile and appalling way.

Resurrection is predicated on death. This is a powerful message in an age and culture in which technology and market economics have created the illusion that life and growth are almost endless. Growth is taken to be always good—and to be fair, growth is often a sign of life. Yet Jesus invites us to remember that unless a kernel of wheat falls and dies it remains a single seed. Jesus himself models a way of living abundantly that is grounded in the unavoidable reality of death.

Increasingly I read stories of billionaires seeking to cheat death altogether. In a culture where medical technologies have extended life among the wealthy to unprecedented levels, Christianity retains a potent voice on the inescapability of death. Even more powerfully, the figure at the heart of the Christian faith, Jesus Christ, signals that a fulfilled and rich life is not by its nature dependent on its length. At a time when religious faith is often parodied as absurd, childish, and fantastical, there is a profound opportunity to speak to the privilege of individuals and societies that seek to isolate themselves from the facts of human existence.

I know that there is nothing much I can do, as an individual, about the use of passing as a euphemism for death. At the same time, I can think of no greater vocation as a person of faith than to speak honestly about death, trusting in that even deeper reality of God’s resurrection.

Complete Article HERE!

Senior suicide

— The silent generation speaking up on a quiet killer

Graham and Bruce from the Ettalong men’s shed in NSW.

Over-85s have become the Australians most susceptible to suicide and a general lack of support is threatening to make the problem worse

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The age group most at risk of suicide may not be the one you expect.

The highest rate of suicide in Australia, for both men and women, is among people over 85, at 32.7 deaths per 100,000 for men and 10.6 deaths for women, respectively.

The global picture is similar. People over the age of 70 kill themselves at nearly three times the rate of the general population. Suicide attempts are also more lethal among older people, with US data showing that about one in four suicide attempts of older people result in death, compared with one in 25 among the general population.

But even these numbers are likely to be underestimates, says Prof Diego De Leo, emeritus professor of psychiatry at Griffith University.

Unless the death of an older person is very clearly a suicide, it is not likely to be investigated, he says, and deaths relating to misuse of medication or even falls that may have been deliberate are often assumed to be the result of senility or frailty.

“It’s widely reported in literature that there’s much more interest in scrutinising the causes of death of a young body than of an old man,” he says.

Helen Bird, 73, from the inner west in Sydney, believes her grandmother’s death fits in this category.

In 1985, Bird got a call to say that her grandmother Olive, 82, had been found in her nursing home room in Hobart with a serious head injury after falling. She died in hospital shortly after. Bird is convinced her grandmother’s death was suicide, knowing that her grandmother had been depressed and had been stockpiling her medication.

Trained nurse Helen Bird
Trained nurse Helen Bird believes her grandmother suicided in a nursing home, although the death was not recorded as such.

“Nothing stacked up,” she said. “I’m a nurse. But nobody ever asked a question. It was a fall, no one questioned it. It was something that really nobody wanted to hear about.

“It’s something that’s always been with me, with great sorrow really,” Bird says. “She felt, I suspect, there was just nothing more to live for, and that’s really, really sad.”

De Leo says there are very different assumptions around suicide for younger and older people. While suicide by a young person is treated as a tragedy and a mystery, an older person’s suicide is often seen as a rational decision.

“It’s this assumption: ‘he was making a balance between pros and cons in life and he discovered the cons were more than pros and he decided then to exit life’, it’s a rational balance,” he says.

Dr Rod McKay, a psychiatrist with a clinical practice focusing on older people, says it is sometimes assumed that someone dying through suicide later in life has less impact on people.

“Someone dying through suicide later in life does have a different impact on those who know them, but it’s not lesser,” he says.

Both McKay and De Leo are keen to draw a distinction between suicide among older people who are depressed and voluntary assisted dying (VAD), which is now legal in every state in Australia under tight restrictions.

“If someone comes to me and says ‘I want to die because I’m depressed and I see no solution to my depression’, well, as a physician I have to do my maximum best to intervene and try to improve the depression of this person, and I can,” says De Leo. “But [if someone comes with] chronic pain, chronic suffering, no hopes for improvement and inevitability of a progression of the suffering … then I feel different.”

McKay says well-meaning attempts to respect individual choices in regard to VAD, may have meant that physicians have not been proactive in referring older people for treatment of depression.

“That debate and the sensitivities everyone is feeling about trying to act respectfully, risks not identifying or investigating depression or reversible factors to the degree that we might,” he says.

A lifeline for men

Men die by suicide at much higher rates than women across all age groups. Among older men, loss of purpose and identity after retirement, weaker connections to children and grandchildren and to social networks can all be factors.

“We’ve never had anyone here who has taken their own life, or entertained that, that I know of,” says Bruce McLauchlan, president of the Peninsula Community Men’s Shed in Ettalong, an hour and a half’s drive north of Sydney, knocking on a wooden work bench. “Maybe, we hope, it’s the contribution of our shed that helps.

“We look for these things: a person who was lively and talkative goes quiet, then we say: ‘Mate, everything OK with you? Anything we can help with?’. Because we are a family,” McLauchlan says.

The Ettalong group, part of the global men’s shed movement, opens its metalworking and woodworking sheds three mornings a week. On a rainy Thursday, the men are just finishing their monthly barbecue lunch, which is sponsored by a local funeral home.

“It’s publicity for them,” laughs Graham Checkley, 84, a retired Baptist minister who is the group’s welfare officer. “We go to a lot of wakes.”

The group is a lifeline for a lot of men, especially after retirement or bereavement. McLauchlan started coming 12 years ago after his wife died. “The men’s shed helps me manage my grief. Otherwise, I’d be sitting at home watching TV all day.”

Garrick Hooper, 73, started coming three years ago after he retired as a taxi driver, and is still coming, “much to my amazement”.

“I always knew about it and I thought: ‘I’ll be avoiding that like the plague, I’m meaningfully employed.’ And then there comes a time that you’re not and you become officially elderly,” Hooper says. “When you retire, you’ve got to redefine yourself, and that’s just how it is.”

Having a laugh together is a big part of the Ettalong Men’s Shed.
Having a laugh together is a big part of the Ettalong men’s shed.

McKay says this sort of social intervention is incredibly important, and older people have far more resilience than they are often given credit for.

“The vast majority of older people don’t feel as old as other people view them as,” he says. “We look at older people, including older people with lots of problems and say ‘I couldn’t cope with that’. Whereas most older people cope well … so we project that on to them.”

Studies show psychological wellbeing actually improves into older age, though depression goes up again in the over-85 age group.

When that happens, McKay says, social interventions are not enough.

“Older people have extremely low access to psychological treatments, the lowest of any age group,” he says.

This can be as a result of unconscious ageism among medical professionals and a sort of therapeutic nihilism that sees depression as an inevitable part of old age and not something that can be treated.

When older people do receive treatment for depression, it can make a huge difference.

“We know that when you look at things clinically, if there is mental illness there, the likelihood of response to treatment is similar to younger people,” McKay says. “There are a lot of social factors that can be addressed, sometimes there are simple medical factors that can be addressed that can make a huge difference in whether someone sees suicide as an option or not.

“It continues to amaze me sometimes when I meet people and see how poor their quality of life is and then with a good review from a geriatrician or a GP who has the time to do it – and it does take time – just the improvement they can have in their quality of life.”

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