Shocking double deaths in Toronto underscores problem of seniors’ suicide

The completely valid concern about suicide among young people has overshadowed an equally serious problem, the rate at which the elderly kill themselves.

The issue was brought into sharp focus this week by the shocking double suicide of an elderly Toronto couple.

Marika Ferber and Vladimir Fiser, in their eighties, died when they jumped from their 18th-floor apartment in suburban Etobicoke. Their bodies were discovered Tuesday morning.

A Statistics Canada overview on suicide noted middle-aged men had the highest suicide rate and that suicide was a leading cause of death among young people aged 15 to 34, based on 2009 data. There's a sharp drop-off in suicide as a percentage of all deaths as people get older, according to the StatsCan data, which leaves the impression there is no problem.

But the suicide rate among Canadian seniors is climbing, an expert told CBC News.

[ Related: Suicide rates climb among elderly in Canada ]

"It seems to be that in this age group, [suicide] is quite common — more so than in younger age groups," said Dr. Robert Madan, the chief of psychiatry at Baycrest.

StatsCan figures for 2009 show men in their late 80s kill themselves at a rate of 31 per 100,000, the highest of any age group. That compares with an overall suicide rate of 11.5 per 100,000, CBC News noted.

The phenomenon is not limited to Canada. According to the U.S. National Institute of Mental Health, older Americans are at disproportionately higher risk to kill themselves. The rate (based on 2007 data) for people aged 65 and older was 14.3 per 100,000, compared with the national average of 11.3. Non-Hispanic white men aged 85 and older had a rate of 47 per 100,000.

A 2000 British study published in Advances in Psychiatric Treatment warned the elderly are seldom considered when debating how to reduce the overall suicide rate.

"Suicidal behaviour in the elderly is undertaken with greater intent and with greater lethality than in younger age groups, and health care staff play a vital role in the recognition and prevention of suicide in this age group," the article observed.

"Although suicide and its prevention remain a significant public health concern, suicide in the elderly still receives little focus in terms of specific preventive strategies or research. This is unfortunate given the established evidence that elderly suicide rates are among the highest, and are in turn more closely related to serious mental illness [especially major depressive illness] and significant physical health problems than in any other group."

The apparent suicide pact of Fiser, 89, and Ferber, 84, is a stark example of the factors that push the elderly to kill themselves.

Lifelong friends who weathered hardship during the Second World War and married after their respective spouses died, the couple was coping with illness, neighbours told the Toronto Sun. Ferber was reportedly tired of living with her chronic leg and back pain and her husband did not want to go on without her, they said.

That's typical, Madan told CBC News. Chronic, debilitating illness can deepen psychological problems such as depression. They begin to feel trapped, with no hope things will get better.

The loss of a spouse and isolation from the family can also deepen depression near the end of one's life.

Picking up on suicidal indications may be difficult for those who work with the elderly, the British study noted.

"There is some evidence that elderly suicides are less likely to express suicidal intent compared with their younger counterparts, raising issues around the detection of the suicidal elderly being a more difficult task than detection in younger people," the article observed.

[ Related: Doctor-assisted suicide ban to be appealed in B.C. ]

Health professionals often fail to spot signs of potential suicidal behaviour, considering it natural that their elderly patients would complain about pain and declining independence. These may in fact mask deeper mental-health problems that could be helped through treatment or counselling.

"Fundamental to this process is the need to educate health professionals and society in general that the act of suicide in late life is rarely a rational act or an unavoidable tragedy," the British article concluded.

The Canadian Mental Health Association produced a tool kit last year to help spot the risk factors and outline ways of helping.

But while aging Baby Boomers may be willing to seek help, older people like Ferber and Fiser often don't reach out, Karen Letofsky of the Toronto Distress Centre told CBC News.

"That generation has possibly grown up not with mental health supports or frank discussions about mental health," she said.