The hidden risks of suicide and depression for seniors living in long-term care

JUDY WOODRUFF: By the year 2030, one in five
Americans will be a senior citizen. And, as baby boomers age, many will eventually
enter long-term care. That move brings difficult choices and challenges
for both seniors and their families. Among the less discussed is an increased risk
of both depression and suicide for those moving into or living in long-term care. Special correspondent Cat Wise reports on
this difficult topic. It’s part of a partnership with Kaiser Health
News. And a warning: This story contains graphic
references to suicide. JANE DAVIS, Daughter: He was fit and physically
just on track to just living this long, long life. CAT WISE: Roland Tiedemann was a lifelong
outdoorsman, a hiker, skier, a member of the Forest Service who taught his daughter, Jane
Davis, to love the outdoors as well. But after so many years of pushing himself,
traveling the world, and serving as a surrogate father to his granddaughter, Jayna, after
her father died, both his and his wife’s health began to fail in 2014. He contracted a vicious case of shingles. His wife, Mary, took a fall while caring for
him, breaking her back. She was subsequently diagnosed with dementia. JANE DAVIS: So, we made the decision to put
them both together in a facility where, in my opinion, I thought that would be the safest
place, that they would get the care they needed. CAT WISE: How did he handle the transition
into long-term care facility? JANE DAVIS: Good question. He — he didn’t. He struggled with it, but he also recognized
it was the only option. I didn’t have the space. I built a place with no bedrooms on the bottom
floor, and neither of them could do stairs. He had his hands tied. And for a man that had made so many decisions
and been able to be so free, now he was confined to this space where he didn’t have a voice. CAT WISE: In early 2018, facing his third
move to another long-term care facility, one that would accept Medicaid, as the family’s
resources dwindled, the 89-year-old locked his door at his nursing home in Wenatchee,
Washington, and jumped to his death from his fourth-floor window. JANE DAVIS: Him being a big writer, I knew
he wouldn’t have left without leaving a note. And a note was found. And he couldn’t write. Remember, he had shaky letters. And it just said, “Sorry, everybody.” CAT WISE: That must have been so difficult. It’s been about a year since he passed. How are you doing now? JANE DAVIS: It’, every day, a different journey. I miss him. He was my anchor. And he was my daughter’s anchor. When Jayna’s dad died, he became her pop-pop. And she misses him. CAT WISE: Davis lived close to the nursing
home, and found it painful to drive by, so she and her daughter recently moved to Colorado. But in the wake of her father’s death, a new
program is being developed to prevent this from happening again. JULIE RICKARD, Psychologist: So, vision loss
leads to social isolation, which then concurs into depression. CAT WISE: Julie Rickard is a psychologist
at Parkside Mental Health in Wenatchee, a 28-bed crisis stabilization center. She’s also the founder of the Suicide Prevention
Coalition of North Central Washington, which she started in 2012 after a rash of suicides,
mostly among young people. JULIE RICKARD: Prior to that, we kind of averaged
between 10 and 13 any given year, but as long as the youth didn’t die, the community wasn’t
saying anything about it. CAT WISE: Then, in 2018, Roland Tiedemann’s
death led her to start asking questions at his facility of the residents, staff and administrators. JULIE RICKARD: What I heard was that there
were other residents that were now considering the same method. And the administration really wasn’t on board. Like, they had no idea, because the staff
hadn’t communicated to administration that there were these other five residents that
were now considering the same method. And what they said was, you know, I always
wondered if that would work, but now I know. The risk is elevated for up to eight months
after transitioning to a long-term care facility. CAT WISE: Sitting in on Dr. Rickard’s staff
training was Kaiser Health News reporter JoNel Aleccia. For the past six months, she and her reporting
partner, Melissa Bailey, have been examining records of over 500 attempted and completed
suicides from across the country in long-term care settings. And she was surprised to find that the rates
of suicide among residents in these facilities don’t differ from seniors living on their
own. JONEL ALECCIA, Kaiser Health News: One of
the things that I think most people think is that, when you send your loved one to a
long-term care facility, in part, what you want is supervision. And from the data that have been available,
it looked like the rates of suicide in long-term care and in the larger community with no monitoring
were about the same. CAT WISE: Is it your sense from your reporting
that this is an issue that is front and center for many long-term care facilities? I mean, are they really tracking the mental
well-being of their residents? JONEL ALECCIA: We found that it’s a pretty
big problem. From the research that we did, up to a third
of the people who are living in long-term care centers have suicidal behavior, either
suicidal thoughts or attempts. And we found that about half of the people
have been reported to be depressed. JIM ELLIS, Assisted Living Resident: Had a
home, a new car. (LAUGHTER) JIM ELLIS: Now I ain’t got nothing. CAT WISE: A year-and-a-half ago, 84-year-old
Jim Ellis moved from a facility in Arizona to Kadie Glen, a 60-bed long-term care facility
in East Wenatchee. He’d already lost his leg to a medical complication,
and says losing his mobility and independence have been hard. He says other residents feel the same way. Has anyone here that you know ever talked
about or said that they’re thinking about suicide here? JIM ELLIS: Oh, you hear it. You hear it practically every day. CAT WISE: You hear other residents talking
about… (CROSSTALK) JIM ELLIS: Certainly. And I have probably said it myself. But that’s talk. CAT WISE: Julie Rickard is working with management
at Kadie Glen, which hasn’t had a suicide, to try to prevent one from happening by screening
residents for depression and suicidal thoughts, teaching staff to recognize warning signs,
and then intervening when necessary. Some families watching this might start to
feel a bit guilty for having their loved ones go into long-term care facilities. What would you say to them? JULIE RICKARD: I would say, you know, there’s
lots of reasons that people go into long-term care. This isn’t about whether it’s a right decision
or a wrong decision. What it’s about is, what are we doing on the
backside to make sure that the person is transitioning well when they are going into long-term care,
that we are doing the things to support them and stay connected. CAT WISE: A big part of that means pairing
people who are not adjusting well with those who are to help them reconnect and reengage
with the community. For Jane Davis, that mentoring piece is key. JANE DAVIS: I think the biggest thing is connection. If you have no connection, if your voice is
no longer heard, why? What’s the why for life? And just having someone to listen to you,
to tell your story to — my dad had a great story. He loved to tell it, but no one was listening
anymore. CAT WISE: For many families, evaluating long-term
care options for their loved ones, just learning the history of a facility can be challenging. Kaiser Health News reporter JoNel Aleccia
says there are no federal requirements to report suicides in long-term care, and most
states either don’t track these numbers or wouldn’t divulge them. JONEL ALECCIA: You would think that somebody
would be watching. And what we found is, it is very difficult
to tell which long-term care centers have had suicides, how your loved one — whether
your loved one is in a place where that might have occurred. CAT WISE: She recommends that families ask
what suicide prevention and mental health protocols are in place. But she cautions that the work being done
in Wenatchee is one of the only programs she was able to find across the country. For their part, Julie Rickard and Jane Davis
say we need to do better as a country of valuing the elderly and to reduce stigma around depression
and suicide. JANE DAVIS: I don’t want this to happen to
anyone else. It haunts you. So, to be able to talk about suicide, to talk
about depression and anxiety and all those issues that stem from long-term stuff that
just isn’t addressed, we need to get rid of the stigma. We need to understand that a person is a person
and talk about it. CAT WISE: For the “PBS NewsHour,” I’m Cat
Wise in Wenatchee, Washington. JUDY WOODRUFF: If you or anyone you know is
feeling depressed or suicidal, please call the National Suicide Prevention Lifeline at

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