I think my elderly father is thinking of taking his own life...
May 14, 2010 8:04 AM   Subscribe

My father recently intimated without saying outright that he was thinking of ending his life. He's 77, has been living with the after effects of strokes for about 15 years or more and has lost his ability to enjoy pretty much all of his passions.

He was a renowned debater and was chosen often to adjudicate debates but he can no longer speak clearly (he had the most amazing baritone voice but now his voice is a permanent muted scream combined with major slurring). Growing up, our entire lounge room was filled with books but now he can no longer read more than a page of a book without suffering from severe headaches. He was physically very strong but now can barely walk. He was always in control of his life, until the strokes, but now he has little say in the day to day running of things.

His wife, my stepmother, is going to have a major operation in a few months time which will necessitate my Dad going into a nursing home and he told me that he feels that he is failing, physically and mentally, and believes that this will not be a respite thing but a permanent thing.

He told me that he has lived longer than his own father and that he is scared. I tried to get him to tell me what was scaring him. Was it physically and mentally failing even more or the prospect of going into a nursing home for good or the thought of ending his life by his own hand? He didn't answer the question.

I can understand why he feels that he doesn't really have much quality of life any more and I empathise so much with him. On the other hand, I love him so much. He is such a major part of my life and the thought of him no longer being here is almost unbearable. On the other other hand, I have to face up to the thought that death is a part of being human and we'll all be gone someday.

Should I try to convince him to leave it up to Nature? Should I tell my brothers and sister what I think he's thinking? Should I tell my step-mother that he's implied he's thinking of ending it himself? She told me that he's being talking a lot recently about what he wants to happen when he dies, and that he feels like he doesn't have much time left but I don't know whether he's actually said to her that he's thinking of ending it himself. Should I just say, I love you and it's completely your decision and I'll go with whatever you want?

My father and I worked together for 10 years (that was ten years ago, before his strokes) and he was in the habit of being more open with me than pretty much anyone else, although in recent years he's kept pretty much everything to himself.

I'm very upset about this, although I'm deeply honoured that he felt able to share it with me, even though his actual intentions are pretty oblique at this stage.

Should I tell the rest of my family about this? I'm so unsure. He rang me today and asked me to come around tomorrow so I'll be seeing him then. Should I try to get him to be clearer about what his intentions are? He's not a man to be pushed into something or away from something.

Do I have the right to, or should I, do more than just listen to him?
posted by anonymous to Human Relations (30 answers total) 7 users marked this as a favorite
Do I have the right to, or should I, do more than just listen to him?

I would certainly tell him how his death will affect you, and encourage him to talk to the other immediate family members, but I don't think it's anyone's place to tell someone else how to live their life or to spread their secrets for the benefit of other people.
posted by Hiker at 8:09 AM on May 14, 2010 [4 favorites]

You may want to contact your county elder services department and inquire about what kind of mental health or other supportive services are available in your area. Through them you can be put into contact with a geriatric social worker who may be able to help you clarify what your role can or should be in this stage of your father's life. A geriatric social worker will also likely know what other supportive resources are available to you and the rest of your family to help you cope with the stress of providing for a sick, elderly parent.
posted by The Straightener at 8:12 AM on May 14, 2010 [2 favorites]

Your father is the nearing the very end of his life. Do you want one the last events between the two of you to be you betraying his trust?

Should I try to convince him to leave it up to Nature?

"Nature" is what gave him the stoke and took away "his ability to enjoy pretty much all of his passions". I bet your father has had enough of "nature", and would like some control over his last days.
posted by spaltavian at 8:13 AM on May 14, 2010 [40 favorites]

What state you live in could have a serious impact on the outcome of this, and your options.
posted by hermitosis at 8:15 AM on May 14, 2010 [1 favorite]

Regarding the loss of his passions, particularly reading: since reading causes him headaches, could he perhaps listen to audiobooks? If he's already got a stereo with a CD player, he could use that, and if he doesn't, perhaps you might give him an inexpensive MP3 player. He might also enjoy podcasts. If that would be too complicated for him, you could go with pre-loaded audiobook players like Playaway. (Some libraries carry this kind of audiobook.)
posted by ocherdraco at 8:25 AM on May 14, 2010

Please, don't betray him! It will make him feel even more powerless.
posted by Tarumba at 8:27 AM on May 14, 2010 [3 favorites]

Your father may not be around for much longer - condolences and best of luck with your situation.

Your siblings will be around for a LOT longer. You should get your father's permission to talk to them about this, because there is a potential for long-term discord if something happens and they find out that you didn't tell them.
posted by infinitefloatingbrains at 8:28 AM on May 14, 2010

There is no right answer to this, but I think you have yours.
It would be such a shame to share it with the MeFites but not with your own Dad. Tell him.

First this:
I understand... I love (you) so much. (You are) such a major part of my life and the thought of (you) no longer being here is almost unbearable.

Then this:
I love you and it's completely your decision and I'll go with whatever you want.

I would not share this with others if those are your father's wishes.

I feel very much for your suffering and wish you courage.
posted by Paris Elk at 8:47 AM on May 14, 2010 [7 favorites]

I hope that you can be as open with your father as he is to you. After all, he has been so honest about his fears, his wishes, and his frustration. Being open and honest about your feelings about him - not just about his illness - will go a long way towards making your last years with him meaningful.

For example, the next time you talk to him, tell him that because you love him so much and he brings so much joy to your life, you hope that he does not opt to kill himself. Tell him that regardless of his physical strength, his mind is still sharp and you cherish every day you have with him. His ailments, as you describe them, likely make him feel meaningless and unneeded. By just telling him that you need him, and that his presence and his wisdom offer you something every day, it might really bring him around. Despair is so sadly common in the elderly because they think they have nothing left to offer. That's bullshit. They've been on this earth for longer than us and have learned so much along the way.

Probe more into his reticence about the nursing home. If he doesn't want to go there while his wife is recovering from surgery, but doesn't think he has any other choices... help him out by finding some other options. Home health care could be one, or you and your siblings chipping in to find a different place to stay, maybe in one of your homes.

Research, on your own, about palliative care. That's health care that doesn't focus on "fixing" people but rather in pain relief. He may be in actual physical pain, or be very afraid of experiencing physical pain. He doesn't have to! A lot of people think that being sore or in pain is just a part of growing old and/or becoming infirm. It doesn't have to be that way.

It might make him feel better to contact a lawyer and draw up a living will and medical power of attorney. You can bring this up if it makes the conversation about his failing health easier. Your dad should be able to describe how he feels about a DNR and lifesaving medical procedures, tell you about it, put his wishes in writing, and get it notarized. You'd be an excellent medical power of attorney for him, since he already trusts you and confides in you.

I hope you'll take this opportunity to really learn as much as you can about your dad and his family before he passes away. Get a tape recorder or a webcam and interview him about his own parents, his childhood, lessons he learned and taught, etc. An oral history is something that your dad can offer than no one else can.
posted by juniperesque at 8:51 AM on May 14, 2010 [7 favorites]

Should I just say, I love you and it's completely your decision and I'll go with whatever you want?


This is exactly what you should say to him and any actions or opinions other than this, is pure selfishness.
posted by nineRED at 9:02 AM on May 14, 2010 [10 favorites]

While a desire to kill himself might seem natural or even rational at this point, he might be clinically depressed. Therapy and/or antidepressants could help. I would ask him to at least consult with a doctor about that possibility. Also, I would work with him to find ways of improving his quality of life. There have been some good suggestions in this thread.

It's possible to be old, in bad health, and even dying without being depressed.
posted by callmejay at 9:09 AM on May 14, 2010 [2 favorites]

My grandfather committed suicide this past October. Now this happened in a different country than we live in but my uncle who lives nearby visited him 2x a day most days and he was pretty much still his own self. The day before the deed he peed himself a little and my uncle without a word grabbed a mop and cleaned up without acknowledging that that happened. My grandfather was a hardnosed farmer and always a very independent man, and we suspect he didn't want his son to deal with what he had to deal with my grandmother (passed away from cancer 3 years previously).

When I was younger he would tell myself (since I'm the oldest of the grandkids) and my mother that one day he would do it if he got too old and couldn't take care of himself, but we always dismissed it in the vein of "Don't say things like that, we will take care of you!" but in the end he did do it.

It still came as a HUGE shock that he did it,but thinking back he did say multiple times that he was going to do it. Sometimes pride gets in the way of clear thinking.

It still hurts and I was pretty angry but now I'm more understanding. Its not like someone else did it so it was entirely his choice.
posted by boomcha76 at 9:16 AM on May 14, 2010 [2 favorites]

Should I just say, I love you and it's completely your decision and I'll go with whatever you want?

posted by equalpants at 9:33 AM on May 14, 2010

It may not be a betrayal for you to tell other family members about this, depending on your Dad's personality and desires. You could ask him, but only you know if this is actually a good idea.

It may be that knowing how much he actually adds to not only your life, but your other family members, would make his life feel more meaningful. Whether that's enough to counterbalance his own pain is up to him.
posted by amtho at 9:37 AM on May 14, 2010

It may or may not be what you want, however there's no reason you father should ever have to enter a nursing home against his will. AFAIK all or most states have existing programs designed to divert people from unwanted nursing home internment, following the Olmstead decision.

Few states are in few compliance, but all should have programs in place.

These programs should allot for, if nothing else, a state-funded medicaid waiver which would allow for in-home care and, in some cases, a family member to be that paid care provider.

Additionally, your state SHOULD have a Department of Rehabilitation Services or some similar program under its Department of Health and Human Resources that should be able to provide information and referral services to help locate community supports for eldercare/activities/and brain injury assistance.

Every state has Centers for Independent Living. You should look up yours and start asking questions. Right now.

My stance on his issue is that its his life and he should absolutely be allowed to do with it as he sees fit. That said, if there are supports and/or programs available that can drastically improve his quality of life, he might find enjoyment there.

As an example, I am currently working with a 53 year old gentleman who had a stroke at 50. At this time, he can say 10 words, but he understands the world around him fully. He can't walk very far, and can't do much with written words. That said, he recently got an assistance animal and a speech-board that he's become quite handy with---and now he's working on figuring out what to do with himself, because being a heavy machine operator is kind of off the table. He's got a lot of self loathing and frustration because he's absolutely alive in there---and he told me the first day that he considered taking his own life. Now things are looking a little better, and he's generally in a pretty good place.
posted by TomMelee at 10:02 AM on May 14, 2010 [5 favorites]

What juniperesque said.

I would see if finding ways to empower him and give him options makes him more interested in living.

Strokes often cause depression, I've heard. It's a regular old side effect of them, like a headache. If he's against anti-depressants he might be willing to take them if you put it like that. It's a little frustrating that his MD didn't prescribe them automatically, but maybe there are reasons he shouldn't be on them that I don't know about.

Basically, if you show him he has options and see if his depression is something treatable and he STILL wants to die, then let him.

I wouldn't tell my siblings if he'd asked me not to.
posted by small_ruminant at 10:03 AM on May 14, 2010 [1 favorite]

My grandfather had a terrible stroke and was reduced from an esteemed professor and head of a scientific research department to essentially a vegetable. My grandmother spent a decade caring for him before he passed away.

When she was diagnosed with terminal cancer, she chose to use her states physician assisted suicide law to end her own life. She wanted to control how she died and not make her children go through what she went through in taking care of her husband.

It's important to respect his desires and wishes, but also important to make sure that he's making the decision from a place of confidence and not because he feels hopeless. As Hermitosis mentioned above, the laws in your state will have a big impact on this.

If he has no legal way to end his life in your state, and he talks to a mental health practitioner, they may force him into treatment and prevent him from ending his own life. So it's important to consider that when you think about your next steps.

I would try to separate the issues that can be addressed from those that - if he's worried about going into a nursing home and doesn't want to lose his independence, talk to him about ways you can solve that problem.

Once you've tried to help him find solutions to every problem that you can do something about, and he feels less frightened, and more in control, he may be in a better place to make a decision and to talk to your whole family about it.
posted by jardinier at 10:57 AM on May 14, 2010 [1 favorite]

I heard the author of this book yesterday. She seemed to have the right mix of compassion and pragmatism. I would seek out as much information as you can from people who have been in a similar circumstance.

It also sounds like your father has a lot to live for: his wife, you, your siblings, their current or potential children. Maybe he just needs to know that he's still loved and needed.
posted by bananafish at 11:47 AM on May 14, 2010

Dad, I'm not done learning from you. I know how much you've lost. How can we help you make your life better?

Your Dad is depressed. With very good reason. Anti-depressants and therapy recommended. Sometimes, people with untreatble medical conditions, who have suffered losses, will eventually choose to die. But he should be able to have a life worth living, and treatment for his depression before he makes that choice.
posted by theora55 at 11:56 AM on May 14, 2010 [2 favorites]

If he has no legal way to end his life in your state, and he talks to a mental health practitioner, they may force him into treatment and prevent him from ending his own life.

The object of outpatient mental health treatment for clients with depressive disorders is to help the consumer manage their symptoms in the community so they don't wind up in a crisis state and being placed somewhere against their will. I think, especially considering that the OP states that "his actual intentions are pretty oblique at this stage" avoiding getting help in the fear that he may wind up in a psychiatric facility against his will is more likely to produce that outcome than prevent it. Nobody can be forced into treatment, but people can be forced into crisis units for observation. People with chronic mental health disorders who voluntarily engage in services in the community have a lessened chance of being placed in an inpatient facility against their will. I've been on locked geriatric psych wards, and they are the bleakest, ugliest places on the planet. I would suggest reaching out and investigating sources of assistance and support in the community in the hopes of preventing an elderly person from possibly winding up placed on an inpatient unit after previously treatable symptoms flared into crisis requiring acute care and observation because they went untreated. And, as unfortunate as many people feel this is, if there is no way for your father to legally and compassionately end his own life in your state and he's hospitalized for physical reasons and reports to a nurse that he has a plan to kill himself, they will take steps they are legally bound to take in order to prevent that outcome.
posted by The Straightener at 12:13 PM on May 14, 2010

Nobody can be forced into treatment

Sorry, but this is just patently false. There's a reason that an entire movement exists to stop forced mental health treatment and it's because people are victims of it every day. Judges can order people to take medication or be engaged in treatment and lock them up when they don't comply. When they are locked up, the treatment is forced on them.
posted by jardinier at 1:58 PM on May 14, 2010 [1 favorite]

Btw, I bring that up, not to get off topic, but to make sure the OP is aware that telling the wrong mental health practitioner that he intends to hurt himself may waive all of his constitutional rights.
posted by jardinier at 2:00 PM on May 14, 2010

I'm sorry for what you're going through. Last year, I lost my dad, and a couple years ago, my uncle (who was in many ways a father to me). My father had recurring bouts of diverticulitis, and was supposed to follow a strict diet, while my uncle's diabetes had gotten worse and his kidneys had begun to fail. I personally believe that had they wanted to keep going, they would still be around today. Both of them managed to outlive their father, which they both admitted was pretty terrifying.

My father had actually managed to survive lung cancer, my uncle had been dealing with diabetes for about 25 years. They got tired of following the rules that kept them alive, but robbed them of enjoyment of life. In their case, they had a choice, there were rules they could follow. In the end, the choice was between following rules that prolonged a life they could no longer enjoy, or enjoying their time at the end of their life.

In your father's case, it's not rules, he has no choices, really, as what he loves, he is incapable of doing. You do have something I didn't have, though, and that's the ability to talk to him, to find out what he's thinking, and to help him in the same loving way that he would help you in his situation. Please, ask him if he wants this to remain private between the two of you, and be prepared to honor that decision. Ask him if he would like other members of the family to be aware and/or involved in this. I know you love him, and it will be unbearable to lose him, but also think of what he'd want. Helping him with his decision, then helping him follow through will likely end better than letting him go through it by himself.
posted by Ghidorah at 2:46 PM on May 14, 2010

Mod note: comment removed - please go to metatalk or answer the OPs question without swearing at other posters.
posted by jessamyn (staff) at 4:12 PM on May 14, 2010

To the poster. Your father is having a very difficult time, and sounds like he is depressed, but he is not chronically ill.

You seem to realize many of the reasons for him feeling like he does so:

How is his hearing? If decent get him to debates as a member of the audience.

Can someone read to him or books on tape?

His mobility may be compromised but there are other ways to get out and about.

He is sharing very real and intimate feelings with you. You should be honored. His fears of death, being transferred to a care facility are real.

I would hope that you encourage him to examine his life in the moment and not in the context of his younger self. I think one of the first reason he will see for living is you.

Keywords: Hospice, Elder care
posted by pianomover at 4:25 PM on May 14, 2010

Ok, let me try again.

"Nature" is what gave him the stoke and took away "his ability to enjoy pretty much all of his passions". I bet your father has had enough of "nature", and would like some control over his last days.

Nature has proven itself beyond our control, the modern world has given easy means to turn our backs on it.

Our fear of sickness and ultimate death leads us to offer others a seemingly logical and easy way to avoid the inevitable unpleasantness.

The logic of cost-analysis and long versus short term value is the chatter of bankers and politicians.
posted by pianomover at 4:37 PM on May 14, 2010

I was pissed when I heard that they took away my grandfathers stash of morphine. Maybe he wouldn't have used it, but he had it for a reason. Not the first, and certainly not the last, of his forced indignities.

Allow him to retain his dignity. Keep his trust. Help him enjoy his life.
posted by gjc at 7:27 PM on May 14, 2010 [1 favorite]

nb going by the spellings "empathise" and "honoured" the OP is probably in Britain, so it's not much use to talk about U.S.-specific standards of care, laws, etc.
posted by zadcat at 9:47 PM on May 14, 2010

Our fear of sickness and ultimate death leads us to offer others a seemingly logical and easy way to avoid the inevitable unpleasantness.

He doesn't appear to be afraid of death. He's afraid of the lack of dignity, awareness and the slow painful decline that he faces. Instead of treating this man as an adult, you brush aside his concerns as if he were a child in the service of some silly principle you hold. "Hospice" and "elder care" sound exactly like what the OP's father is trying to avoid; but you know best, right? He's an old man, why should he know anything, right?

So much has been taken from this man. pianomover's advice is take away the very little he has left.
posted by spaltavian at 7:03 AM on May 15, 2010

My grandfather was very, very close to doing this very same thing. He's had seven different types of cancer and is missing several organs as a result. He had three heart attacks in one year. To top it off, he had one of the best vacations of his life right before all this happened. So, he knew exactly what he was missing.

I think out of the family, I was the only one he told. I tried to reason with him, but I was just arguing logistics instead of begging for him to stay on this planet. Basically, I totally understood; I just wanted him to go out cleanly for my grandmother's sake. I wanted him to stop talking about falling into a table saw or blowing his brains out.

So, this is what my comment comes down to: This situation is really, really common. During one of these conversations, we had telephone service technicians milling around and outside the house trying to fix an outage. They heard us talking, and those two guys did not take my side at all because their own grandfathers had committed suicide. We did come to an agreement that it was not our jobs to spread the confession to more official parties because of the consequences - psychiatric committal, endless streams of new medications, other such general BS that already made being old difficult and pointless.

If the man wants to go, help him find a clean, respectable way to go. Can you move him to a country or state that has legal euthanasia? I was readying myself to make my grandfather a short-term legal resident of Oregon at my own expense for this reason.
posted by fujiko at 8:22 AM on May 15, 2010

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