Introduction
The process of demographic aging of the population is a global phenomenon; it occurs in all developed countries of the world, and Australia is no exception. The aging of the Australian population is the result of increasing life expectancy and low birth rates following the post-war baby boom. Population aging has been an issue that has strongly influenced the range of social policy for more than twenty years. This has led to a mandatory old-age pension for employees and a progressive increase in the retirement age to extend the duration of employment.
At the same time, demands for elderly care increased as the market economy turned to the skills of women, who have usually been the main providers of unpaid care in their households and extended families. Increasingly, these concerns are shifting to the growing sector of the market for workers trained to care for the elderly and children. One of the recent severe social issues that the Australian elderly population has experienced is the increased number of suicides in Australian men over 85 years old. The suicide rate for this age group is more than three times the national average, according to data released by the Australian Bureau of Statistics (2021). Overall, the rate of suicides among elderly people in Australia of both sexes is concerning, and interventions are in order to alleviate the problem.
Statistical Data
The Australian Bureau of Statistics (2021) notes that the conclusions about increased suicide rates among the elderly may not seem obvious to readers, as it is traditionally believed that the highest risk of suicide is among young men. However, while this is true for the net number of suicides, the picture changes when differences in the age distribution of the population are taken into account.
For example, men over the age of 85 accounted for a relatively small proportion of all male suicides in 2020 – 3.1% latest available (Australian Bureau of Statistics, 2021). However, the suicide rate in this age group was 36.2 deaths per 100,000 people, as compared to 32.3 per 100,000 in 2019 (Australian Bureau of Statistics, 2021). For women over 85, this figure was significantly lower – 6.2 deaths per 100,000 people (Australian Bureau of Statistics, 2021).
The next most frequent indicator was in men in the age groups of 40-44 and 50-54 years – 27.1 per 100 thousand (Australian Bureau of Statistics, 2021).At the same time, 12.1 suicide fatalities per 100,000 individuals occurred in Australia in 2020 (Australian Bureau of Statistics, 2021). According to the data, older adults are increasingly committing suicide.
Many researchers emphasize that older people are not addressed in public speaking or policy directives. For example, the National Mental Health and Wellbeing Survey, published in Australia in July, did not include data on people over 85 years of age. As in all other age periods, statistical data on the frequency of suicides always remain below the real indicators. This is due to the fact that only so-called direct suicides are taken into account, excluding, for example, situations of refusal to eat and deliberate non-compliance with doctor’s orders.
Marital status, being an important prerequisite for social integration, plays a significant role in predicting suicidal risk in the elderly. Unmarried men of all age groups usually have a higher risk of suicide than married men (Crestani et al., 2019). Most studies reveal a higher risk of suicide among divorced people of both sexes compared to those who are out of wedlock for another reason. However, the relationship between divorce and suicide risk is complex.
For example, a chronic illness of one of the spouses, both in itself and as a factor that worsens the material wellbeing of the family and the quality of life of the partner, often causes divorce. For situations like this, divorce is likely to act as a proxy for suicide risk. Widower status is associated with an increased risk of suicide in men over 50 years of age (Crestani et al., 2019). Widowers, especially in the 1st year after bereavement, have a higher risk of suicide compared to widows (Crestani et al., 2019). Summarizing, it can be concluded that the risk of suicide, depending on marital status, decreases in the following sequence: divorced – widowed – single – married.
Causes of the Issue
Many physical and material circumstances contribute to a high risk of suicide at this age: weakness, chronic pain, bereavement, and financial problems. However, researchers believe that not only and not so much external problems bring people who have lived to a ripe old age to suicide. The feelings of loneliness and existential crisis increase older people’s frustration with life and add more stress to their lives, already troubled by aging and comorbidities (Brooks et al., 2019). These beliefs may coincide with major life changes: retirement, no longer being able to drive a car, or moving to a specialized facility where they are often left alone by relatives.Such stressful events can increase feelings of marginalization, loss of independence, and worthlessness and lead to social exclusion (Brooks et al., 2019). At the same time, experts consider suicide prevention a problem in this group since older people are generally not inclined to seek psychological help and are more likely to react negatively to any formal events.
Another factor that significantly increases the risk of “late” suicide is living alone and the phenomena of almost complete isolation associated with this. This is clearly seen in the example of people in nursing homes. Even in the absence of contact with relatives, interaction with staff and living together reduce the risk of suicide (Brooks et al., 2019). In such cases, and with a high indicator of suicidal ideation, the frequency of attempted and completed suicides is low. The vast majority of such cases occur in people who have been in a nursing home for less than 12 months (Crestani et al., 2019). This trend is revealed both in the cohort of people who need constant medical supervision and among those who receive assistance only in coping with everyday activities.
Some of the macrosocial factors that are suicidal for the young, such as unemployment and job insecurity, are losing their significance for the elderly, giving way to others, such as gerontophobic attitudes in society. The consequences of this form of ageism are exclusion from social and cultural life, insufficient representation of the problems of older people in the media space, and their exclusion from social life (Crestani et al., 2019). Age discrimination is especially dangerous in the early stages of society’s modernization. Progressive modern changes in the family structure are superimposed on the continuing practice of delegating the functions of caring for the elderly to representatives of the younger generations.
The medical and psychological consequences of a suicidal act committed in old age are much more serious than at a young age. In mature people, the intention to die is not a momentary decision and has a more solid basis. Their methods for implementation are more thoughtful and potent, and the chances of recovery after a failed suicide attempt due to the burden of somatic diseases are not high.
Government Structures Responsible for Tackling the Issue
The main government structure responsible for managing the mental health of the population, including suicide prevention, is the Department of Health and Aged Care. According to the Department’s official website (2022), it is responsible for “developing and delivering policies and programs and advises the Australian Government on health, aged care and sport” (para. 1). On this level, specialized, state- and national-level interventions are designed and implemented, together with the federal government of Australia.
Seeing that the issue of mental health of elderly people is a rather specific social and healthcare issue, the Department of Health and Aged Care bears the primary responsibility for resolving it across the country. It has already implemented various programs for suicide prevention, such as Suicide Call Back Service, Lifeline, Stand By Support After Suicide, National Suicide Prevention Trial, and many others (Australian Government Department of Health and Aged Care, 2022). The Department works together with other governmental structures to ensure that sufficient funding, resources, support, and legal aid are provided in the process of designing new interventions and programs and enhancing the existing ones.
As a rule, more attention is paid to certain aspects of committed suicides and the reasons that caused them. The problems of prevention are studied by the analysis teams of the Department in the context of social, psychological, pedagogical, legal, and medical components. Moreover, they also review the suicide rate in relation to the categories of the population and to the spheres of professional activity of citizens. The coordinated activity of state bodies and local administrations in a single system is considered the basis for the development and effective implementation of the most important policy documents in the field of suicide prevention. However, its’ work is not limited to statistical records and hastily taken measures in response to the received acts of the government’s response.
The work of the Department involves an analysis of the nature of the impact on the population and individual citizens of specific environmental factors that cause a life crisis, resolved by a destructive mode of suicide. The system provides the center with operational feedback from the regions and municipalities. This ensures the receipt of complete and reliable information about the dynamics and trends of the process and the conditions and circumstances that contribute to the emergence and implementation of suicidal thoughts among the population. Finally, the Department works closely together with other federal and local authorities to ensure the timely adoption and subsequent clarification of state decisions to neutralize negative environmental factors.
Proposed Policy to Assist in the Solution of the Issue
Increasing the availability of psychiatric care for the aging population and carrying out measures for the secondary prevention of suicides are necessary conditions for reducing the rates of the latter. However, it should be taken into account that the results of such processes are of a “delayed” nature. It leads to a transient dissociation between relatively high indicators of the “human development index” and a high level of suicide in old age. A logical result of continued economic growth and the formation of an effective healthcare system is, after all, a decrease in the level of suicides among the elderly.
The recent policy introduced by the Australian Federal government is aimed at providing effective healthcare for the population and reducing the suicide rate by facilitating the employment of elderly care workers. The authorities have pledged to fund wage increases for aged care workers in a submission to the Labor Relations Arbitration Commission (Remeikis, 2022). The commission is considering demands put forward by the unions, including a call for a 25 percent wage increase for 200,000 workers in the nursing and caretaking sector (Remeikis, 2022).
The federal authorities did not specify the amount of the premium but emphasized in their submission that the existing rates do not reflect the value and qualifications of the sector. Remeikis (2022) reports that “Australia’s aged care workers have won a 15% pay rise, with the possibility of more to come, after the Fair Work Commission accepted the sector’s employees were underpaid” (para 1). The health workers union welcomed the government’s submission, claiming that an aging population and changing expectations have made their jobs more difficult.
Conclusion
Thoughts about suicide in old age arise against the background of a psychological crisis due to mental and somatic disorders, inadequate living conditions, loneliness, and loss of social status and meaning in life. The provision of timely and professional healthcare and attention to elderly people plays an important contributable in the prevention of suicides among them. Aging people face many health-related struggles that contribute to the destabilization of their mental condition and often alienate them from their families due to feeling “like a burden.” Moreover, elderly people require more attentive and gentle care due to their fragility, as well as the increased need for positive human interaction. With the help of the policy, he introduced, aged care workers, will be remunerated better in the future, thus increasing their motivation and emotional and financial stability to provide high-quality assistance to the population.
References
Australian Bureau of Statistics. (2021). Causes of death, Australia. Australian Bureau of Statistics Website. Web.
Australian Government Department of Health and Aged Care. (2022). What we’re doing about suicide prevention. Australian Government Department of Health and Aged Care. Web.
Brooks, S. E., Burruss, S. K., & Mukherjee, K. (2019). Suicide in the elderly. Clinics in Geriatric Medicine, 35(1), 133–145. Web.
Crestani, C., Masotti, V., Corradi, N., Schirripa, M. L., & Cecchi, R. (2019). Suicide in the elderly: a 37-year retrospective study. Acta Biomed, 90(1), 68–76. Web.
Remeikis, A. (2022). Australia’s aged care workers win 15% pay rise and minister says it’s the ‘first step’. The Guardian. Web.