• The suicide of the elderly is much less studied than that of the young, according to our partner The Conversation.

  • This is perhaps explained by the more shocking nature of the death of young people, which is moreover by suicide, than that of people who are said to have "made their living".

  • The analysis of this phenomenon was carried out by Frédéric Balard, anthropologist at the University of Lorraine.

Thanks to the Covid-19 pandemic, the question of suicide has benefited from a media light which has undoubtedly not taken place since what was called the “suicide crisis” of France Telecom in 2009.

However, between these two periods, the number of suicides in France has not experienced any real upheaval, fluctuating around 9,000 to 10,000 per year even if the trend has been towards a drop in rates since the early 1990s.

While suicides among young people and suicides at work are the subject of much research, suicide among the elderly is proving to be much less studied.

Yet suicide rates increase with age.

If we refer to the figures of the National Suicide Observatory, 15-24 year olds have a suicide rate of 5 / 100,000 corresponding to 373 suicides for the year 2014 while that of people aged 75 or over is 35.4 / 100,000 (1,749 suicides in 2014) and even rises to 83.8 / 100,000 for men aged 85 to 94 (458 suicides in 2014).

This observation of the rise in suicide rates with age is not new since Émile Durkheim already mentioned it more than a century ago.

Therefore, how can we understand that these suicides are not the subject of a concern at the height of the aforementioned rates?

Several hypotheses can be put forward.

First of all, the fact that suicide represents a minor cause of death at advanced ages (0.5%) whereas it is major among young people (16.2% for 15-24 year olds).

Then, perhaps because the death of young people, which is more by suicide - the paragon of bad death - appears more shocking than that of the elderly who are said to have "made their life".

Defining suicide

Out of loneliness, depression or for other reasons, many elderly people decide to end their life in France, a phenomenon that is still little studied © The Conversation CC BY-NC-ND

In order to be able to analyze and interpret a phenomenon properly, it is first of all a matter of properly defining it. However, concerning suicide, this turns out to be more complex than it seems. The suicides to which we have just referred are the suicides counted. For them to be, it is necessary that the mention "suicide" be present on the death certificate. However, in the research that we have carried out, certain suicides have not been notified as such, which confirms that the rates (at all ages, but particularly in old age) are underestimated.

Then, depending on the publications, the definitions of suicide and suicide attempts differ.

For Durkheim, “suicide is any case of death which results directly or indirectly from a positive or negative act performed by the victim himself and whom he knew should produce this result.

The attempt is the act thus defined, but stopped before death results ”

However, other approaches broaden these definitions through the idea of ​​passive suicide.

Thus, the "slip syndrome" which has been discussed a lot in nursing homes during confinement episodes is sometimes considered as suicide.

Some go further in the definition through what they call the suicidal equivalents (serious negligence in the hygiene of life, Münchhausen syndrome, risky behavior, assisted suicide, euthanasia, etc.) that they consider come under the same mechanisms as suicide.

These differences in definitions reveal different conceptions of what suicide and attempted suicide are and are underpinned by divergent scientific paradigms leading to interpretations that are difficult to reconcile.

Is senior suicide a different suicide?

Elderly person with pillbox © Sabine Varnep / Pixabay

If the suicide of the elderly is singular from the point of view of suicide rates, it is also singular from the point of view of the ratio of suicide attempt to completed suicide.

Indeed, while young people under 25 have a ratio of 200 suicide attempts, that of people aged 65 and over is 4 to one.

The hypotheses used to explain these differences are physiological fragility and isolation reducing the possibilities of "help" and greater intentionality.

Studying the suicide of the elderly leads us to question the notion of age and its forms of medicalization.

Some studies consider age (and male gender) as a risk factor.

However, how does that make it an explanation or, to put it another way, how being a man over the age of 85 helps explain a higher prevalence?

It is interesting to note that age is a thorn in the side of anyone who would be tempted to apply in a simplistic way the two main predictive “elements” of suicide usually retained: suicide attempts and depression. Indeed, we note that not only suicide attempts decrease with age, but the same is true for characterized depressive episodes.

These elements lead us to consider the suicides of the elderly in a particular way.

For suicidology (a specialty working to prevent suicide), the depression of the elderly would be a specific depression and more difficult to diagnose.

Prevention of depression would therefore be the first lever for reducing suicide and one could hypothesize that it is this prevention that has led to the drop in rates since 1990.

Our "SUICIDE" dossier

Another interpretation of this decrease would tend rather to consider that it is explained by suicides prevented by more drug and physical restraint (which we find it difficult to call prevention) and an increased physiological difficulty in carrying out suicide.

These reflections raise major scientific issues, the investigations of which are sometimes hampered by ideological brakes and forms of moral panic leading to refraining from any reasoning aimed at questioning suicide and assisted suicide (see euthanasia) even though these reflections appear to be heuristic. if only to compare the experiences of relatives.

Among the other explanations for suicide among the elderly that can be found in the scientific literature, mention is made of polypathology, loss of autonomy, isolation, loneliness or even the anguish of death. .

Thus, it is the losses linked to age that are called into question, widowhood, entry into an institution, the feeling of loss of meaning which would lead some people to suicide.

It is finally evoked "suicides in anticipation" to avoid the decline and a death that goes on forever.

These suicides are thus interpreted as forms of disappointment or, conversely, as an attempt to regain control of the end of life.

What research protocols to study suicide?

If the explanations presented are more hypotheses than causes of suicide, it is because the construction of an ideal research protocol is proving difficult.

In fact, suicidology mainly implements two types of protocol to analyze suicide: the survey of suicidal persons (people who have made suicide attempts or who present "suicidal behavior") and the psychological autopsy which consists in reconstituting post mortem, via documents and testimonies of relatives the reasons for the suicide.

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Obviously, these protocols are not without weaknesses. In the first case, we presuppose that suicides and suicides are comparable, which is not demonstrated and even less so in the case of the elderly, most of whom have never made suicide attempts or have never been in a state of death. suicidal behavior. The work based on psychological autopsy, which suggests that 60 to 90% of suicides suffered from mental disorders, have important limitations. If the detection of depression in the elderly is underdiagnosed because it is complex, it is difficult to justify that it can be easily diagnosed post mortem.

The sociological interviews that we have conducted with relatives of elderly people who have committed suicide show above all that, depending on who is speaking, the context of the interview and the relationship he or she had with his or her deceased relative, the reasons for suicides reported will be very different.

Thus, these accounts learn less about the motives and causes of suicides than about family history and the place of the elderly parent in it.

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This analysis was written by Frédéric Balard, anthropologist at the University of Lorraine.


The original article was published on The Conversation website.

Declaration of interests

Frédéric Balard is a lecturer in sociology in Nancy & editor-in-chief of Gerontology and society.

The 'Suicidage' study project was supported by the Fondation de France.

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