Suicide is not just the leading cause of fatal injuries for teens. It’s also the leading cause for Hawaii seniors ages 65 to 74 — and it’s trending upward, the latest statistics show.

Family members and physicians alike need to pay more attention than ever to early warning signs of depression in seniors, health experts told a crowd of caregivers at a conference Wednesday.

A four-member panel of doctors and social workers asked for broader community help in caring for Hawaii’s kupuna. Citing the state’s rapidly aging population, the group called for more mental health screenings and changes in hospital practices that could save lives.

Ritabelle Fernandes, a geriatrician who teaches at the University of Hawaii medical school and works at the Kokua Kalihi Valley clinic, said one of the biggest issues doctors are facing today is they have no time.

“Doctors only have about 10 to 12 minutes with a patient. That’s what it boils down to,” she said. “What can you do in 10 to 12 minutes? It’s very hard to screen patients for depression, very hard to screen patients for dementia, because it takes time.”

Fernandes urged health care professionals, nonprofit volunteers and social workers to help doctors by taking advantage of early screening tests. For instance, elderly people who have had a stroke or have diabetes are at much higher risk of depression, she said.

Another way she said seniors can receive better care is if the caregivers — often immediate family members — accept help. Fernandes said there are many free services and hospice programs that can give primary caregivers the support they need, but too often they are reluctant to accept it.

Gary Powell of The Caregiver Foundation said caregivers often face their own mental health struggles. He said many start to feel they are the only people who can care for a senior and they neglect their own lives.

Seniors benefit when caregivers effectively cope with their feelings of resentment, anger and guilt, Powell said. As a result, both sides are healthier and everyone benefits.

Swinging Pendulum

Hospitals and other healthcare facilities exacerbate the problem of suicide among seniors when they discharge depressed patients prematurely, Fernandes said.

Fernandes explained how the pendulum in America has swung from over-hospitalization of mental health patients to not enough. She said the way things work now is that in essence, if a person is not going to kill themselves that day, he or she is sent home.

“It’s a policy issue,” Fernandes said.

Marya Grambs, executive director of Mental Health America of Hawaii which organized the conference, said 70 percent of seniors who kill themselves saw a doctor in the past month.

The Hawaii rate of suicide for seniors is generally lower than the national average from ages 60 to 84, but the state’s rate rises sharply among residents 85 years and older, according to the most recent Department of Health report on injuries in Hawaii from 2007 to 2011.

There are other meaningful steps people can take to reduce the suicide rate for seniors.

Dr. Tom Harding, a neurologist who treats people with dementia, underscored the importance of the words people use. He said he has heard doctors tell a patient, “Well, there’s no hope.” And he’s heard caregivers say, “It’s OK if it doesn’t get better.”

He said he tries to instill hope in patients by talking about treatments, spending ample time with them going over the bad news of a diagnosis.

Fernandes listed some early warning signs suggesting a person needs to seek professional help.

“If the person finds they are unable to do the thing that they used to do — it’s difficult to get out of bed, they stopped going out, they’re not eating, they’re losing weight and they have clinical signs of depression — that’s something to go and talk to your doctor and get evaluated,” she said.

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