Caregivers and Suicide

excerpted from the Tampa Tribune:

Caregivers may look to suicide

By Gary Joseph LeBlanc

The rate of homicide-suicide in senior adult couples is 50 percent higher than younger adults. Those who suffer from Alzheimer's, the so-called Caregiver-Dependent Homicide-Suicides make up a large percentage of senior deaths. When a couple who has been married for a long period of time becomes totally dependent upon one another and one or both become irreversibly ill, homicide-suicide may appear to be the only answer. Periods of deep depression may trigger feelings of utter hopelessness, especially on the part of the husband who feels helpless in realizing he can no longer fulfill what deems to be his husbandly duties. This usually has the husband initiating the act. Do not interpret this as a suicide pact; this is an act of desperation and hopelessness.

One caregiver resource report showed nearly 60 percent of caregivers experience clinical signs of depression and 40 percent of former caregivers have mild to severe depression which can last up to three years after the patient has died.

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My Commentary:

Honestly, who doesn't think of suicide when you're living with a debilitating chronic condition that sucks the joy and vitality out of your life - whether you're the patient or the caregiver. I know I have found myself in moments of unrelenting pain thinking about death as the only cure. Having the option of suicide always available ironically allowed me to chose life -- because I knew that death was within a few pill's reach away. I could always swallow that handful tomorrow.

I would really like to know - have you ever considered suicide as your "cure?" What kept you from doing it? What thoughts ran through your mind that made you chose life?

Mercy Killings?

What I would like to know is: have ever thought about suicide as a way out? Have you ever said to yourself, "I want this to end!"

Have you and your partner ever talked about this with each other? Richard and I had a suicide conversation after I had been in constant level 12 pain (on the 1 - 10 scale) for 9 months with no relief in sight and no healers on the horizon. I found it surprisingly comforting to know that I had this option. In fact, just knowing that I could walk through the door to oblivion gave me strength to continue to endure and seek more healers.

Do you think that suicide can ever shift from psychological pathology to reasonable choice?

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From an article on the Atlanta News on elderly mercy killings by Marcus Garner:

In a two-week period last month, murder-suicides claimed the lives of two Metro Atlanta couples in their ‘80s.

In both cases, the husband was the caretaker of an ailing wife. And in both cases, the man shot and killed his long-time spouse before turning a gun on himself.

Were these deaths the result of depression, some level of domestic abuse, or were they the actions of a benevolent, merciful spouse?

Edward Travis, 86, executed a carefully-thought-out plan to kill himself and his wife of 60 years, 85-year-old Anne, who suffered from dementia.

George A. Doby, 87, killed himself after fatally shooting his 85-year-old wife, Edna, who suffered from Parkinson’s Disease.

Experts say assisted suicides among elderly couples aren’t that uncommon, and such arranged agreements are becoming more popular in Europe. The Violence and Injury Prevention Program in Tampa Bay, Fla. estimated between 300 and 500 murder-suicide deaths nationally each year of people over the age of 55.

Maggie Beck-Coon, with the Georgia Commission on Family Violence, sees them as one person exerting power over another. “I’m very troubled by the whole language of ‘mercy killings,’ because I don’t think I feel comfortable with someone else determining when you should die,” said Beck-Coon said.

Dr. Patrice Harris, a psychiatrist and director of Fulton County’s Department of Behavioral Health and Developmental Disabilities, cautions not to rush to judgment, however. “Often times, when people are thinking about suicide, they are feeling hopeless and helpless and see no way out of their situation,” Harris said. In particular, Harris said taking care of an ailing spouse late in life can add to the day-to-day stresses many elderly face: losing peers and family to illness and death, retirement, or dealing with one’s own deteriorating health.

Relatives of the Travis and Doby couples pointed to this hopelessness. “He didn’t want to be a burden,” Alan Doby said, speculating the motives of a father he described as proud. Mary Travis cited a letter from Edward Travis in characterizing his as a “mercy” killing: “‘I believe that everyone concerned will get along with me and Anne out of the picture,’” she read from the letter.

Illness Suicide Pact

Warning: this is a tough, sometimes forbidden topic to bring up - the topic of illness and suicide. Raising the topic of suicide is by no means an endorsement of it. And I don't believe that talking or reading about it pushes people to do it. I am a believer that what you don't acknowledge can be more harmful than what you do. In this spirit, I offer an article about a couple who entered into a suicide pact. Read it if you want to. Don't read it if it will disturb you. If you are having suicidal thoughts, please get help - see a therapist, a clergy-person, or call a suicide hotline like the National Suicide Prevention Lifeline at 1-800-273-TALK

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Can you imagine a set of circumstances that would drive you and your partner to decide that double suicide is the only solution left?

I can. It's terrible for a couple to bear the debilitating illness of one partner. When both are sick and suffering, how is that to be borne? Illness, pain, and loneliness without resources or community can make "dusty death" seem like a better place than the "walking shadow" of life. I think some who suffer debilitating illness at some point, maybe only once, think about suicide as a relief.

Most don't take action. Some do. It's not for us to judge. Only to try to hold with compassion the realities of people's stories and wonder along with the writer in the story below -- what went through their minds at the end.
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from News.co.uk. February 11, 2009

Inquest told of couple's suicide pact

A pensioner was found dead in the back of his car following a pact with his wife that they would both end their lives, an inquest has heard.

Dennis Bramble, 85, of Garnett Avenue, suffered from a heart condition and his wife, Dorothy, was terminally ill with cancer. Mr Bramble did not want to be on his own should his wife die.

On the evening of October 6, 2008, the devoted couple had sat in the back seat of their car parked in the garage and taken morphine and temazepam to send them to sleep. It was then intended that Mr Bramble would turn the car engine on.

The following morning Mrs Bramble was found crouched down outside the garage by her daughter, and Mr Bramble was found dead in the car.

A post-mortem examination found he had died from a mixture of morphine and temazepam in his system. The car engine had not been turned on but the car headlights had been.

Mrs Bramble told police that she and her husband had gone into the garage at 6pm the night before. She said she had struggled to get out the car and when she finally did it was daylight and her husband was still breathing heavily, at which point she realized it was all 'going wrong'.

A diary documenting how bad things were for them both was found. Mr Bramble was becoming forgetful and Dorothy was often in agony with her illness.

It is still unclear what was going through his mind at the final moments.

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I'd like to know:

Have you ever reached the point of utmost despair and contemplated suicide? What kept you from taking action? What made you choose life?