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What to Say When a Senior Says, “I Just Want to Die.”

It's a statement that caregivers hear all too often from their elderly loved ones: "I can't handle this anymore—I just want to die."

How are you supposed to respond to such a declaration?

Furthermore, how are you supposed to personally cope with the fact that the care you're providing doesn't seem to be enough?

Margaret Sherlock, M.A., Clinical Director of the Behavioral Health Program & Assessment Program Services at the Visiting Nurse Service of New York (VNSNY), offers some advice for caregivers dealing with this difficult situation:

  1. Don't ignore it: Sherlock says that the painful emotions surrounding the topic of death can sometimes make caregivers "allergic" to having honest, open dialogues with their elderly loved ones. If your loved one keeps saying that their life is no longer worth living, or that they would be better off dead, Sherlock says that you can help by asking questions to get them thinking about ways they might be able to cope with their situation. Queries like, "Why do you feel that way?" and "What would you like to be different?" can help a senior focus on the facts of a situation, instead of getting caught up in their feelings of pain and helplessness. If your loved one is suffering from Alzheimer's or another form of dementia, they may not respond to these questions. In this case, a caregiver should address the issue of incessant suicidal comments by attempting to distract the senior from their gloomy train of thought by changing the subject to something more pleasant.
  2. Set limits: While it's important to know when to talk to your loved one about their feelings, Sherlock emphasizes that it's also vital to know when to stop talking about them. She suggests setting aside some time each day to discuss the tough stuff. That way, difficult dialogues don't pop up out of the blue, which can be emotionally draining. If your loved one tries bringing up the topic ahead of schedule, you can gently remind them that you both agreed to set aside time later on to talk about that issue.
  3. Be realistic: As a caregiver, you may feel hesitant about acknowledging that your loved one is near death, but they may be well aware of their condition and want to talk about it. "People with suicidal thoughts want relief from their psychological distress and a caregiver can provide comfort by engaging in mater-of-fact conversations," Sherlock says. While it may be painful, having end-of-life discussions with your terminally ill loved one can help them process their feelings as well as allowing you to make sure that their last wishes are carried out in the way they want them to be.
  4. Look out for signs of depression: As always, it's important for a caregiver to be vigilant when it comes to monitoring their loved one for symptoms of depression. Persistent lamentations about wanting to die could be a sign that your loved one is suffering from this mental disorder. According to Sherlock, common symptoms of depression can include: constant feelings of sadness and anxiety, loss of interest in activities that they used to enjoy, sleeping too much or too little, loss of energy, irritability, and loss of appetite.

Sherlock also stresses the importance of taking time for yourself, particularly when you're dealing with a loved one who keeps saying they want to die. A caregiver can become so overwhelmed by their loved one's constant air of doom and gloom that they may end up becoming depressed themselves. She suggests recruiting other family members, or a respite care provider to help you get some time away from your caregiving duties.

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