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    Murder-suicides in Elderly Rise

    Husbands commit most murder-suicides -- without wives' consent.

    Undiagnosed and Untreated Depression

    It's not clear why more and more elderly men -- the murderers are almost all men -- are depressed enough to kill themselves and their wives. One reason may be loneliness, says Patrick Arbore, Director of the Center for Elderly Suicide Prevention at the Goldman Institute on Aging. He points out that more and more seniors live isolated from their friends and families.

    In one study of an area in Florida, Cohen found that two-thirds of the men who killed their wives and themselves had visited their doctors within three weeks before committing the deadly act. None, however, were being treated for depression.

    But a doctor is unlikely to diagnose a condition like depression in a six-minute office visit, partly for lack of time and partly because older people tend to put up a good front in the doctor's office.

    "We can't really pass the buck to the physician here. It's important for adult children and members of the community to pay attention and to listen -- to really listen -- to what these older people are saying," says Arbore. "Sometimes comments like 'I'm going to kill myself' are so provocative that we can't believe it and let it go by."

    Changes in eating or sleeping, talk of feeling helpless or hopeless, loss of interest in activities, or giving things away are all signs of depression. In addition, Cohen says adult children should be aware that the following situations are risk factors for homicide-suicide:

    • The couple has been married a long time and the husband has a dominant personality.
    • The husband is a caregiver and the wife has Alzheimer's disease or a similar disorder.
    • One or both have multiple medical problems, and the health status of one is changing.
    • A move to a nursing home or assisted living facility is pending or under discussion.
    • The couple is becoming more socially isolated, withdrawing from family, friends, and social activities.
    • The couple has been arguing or there is talk of divorce.

    Getting Help

    Cohen urges adult children to come right out and ask a parent if he has thought about suicide or homicide-suicide. "Don't worry about giving them ideas," says Cohen. If the answer is yes, ask them about their plans. The more detailed the plans are, the more likely they'll be carried through, she says.

    If you believe there is a risk for homicide-suicide in your family, call a suicide crisis center, a suicide hotline, a family physician, a psychiatric or medical emergency room, or a community mental health center. And if there is a gun in the house, remove it. Cohen notes that areas of the country where gun laws are stricter, such as the northeast, have much lower homicide-suicide rates than those where firearms are more easily available.

    "People think about killing themselves or their partner for weeks, months, even years," she says. "Be alert to signs of depression and get help quickly."

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