EVERY morning my friend visits a Melbourne nursing home to help his mother get out of bed and dressed for the day. Every morning, without fail, she tells him that she wishes she were dead.
Welcome to the darker side of healthy ageing. This otherwise bright, elderly woman, who does the daily crossword in a flash, has outlived her husband, sold the family home and inhabits a limbo land for the frail, infirm and absentminded.
Depression among the elderly is more widespread than we think. News this week that elderly people in France commit suicide at a rate of 62 a week sounded like one of those incredible wire reports from a remote Siberian province announcing the birth of triplets to a 76-year-old woman.
A French parliamentary report into aged care has revealed that 3232 people over 65 kill themselves every year. The report was commissioned following summer heatwaves when relatives failed to identify and claim the bodies of hundreds of elderly people who had expired in sweltering 40C-plus temperatures.
Grim evidence of society's double standards: a baby left in a car on a hot day provokes public outrage and prosecution, but elderly people are almost regarded as dispensable with philosophical admissions that they have, after all, enjoyed a good innings.
Elderly suicide is one solution to the cost of financing aged care that will be missing from Australia's forthcoming Hogan report into the nursing home industry. Australia lags well behind France in the suicide index, but our rates for men over 75, a demographic cohort known as the "old-old", remain stubbornly high.
Youth suicide grabs the headlines but, given our ageing population and policies aimed at keeping elderly people at home, we will have to be more alert to the potential for social isolation, loneliness, and other triggers for depression and suicide, particularly among older men.
High levels of career mobility pulling children interstate and overseas, unprecedented levels of family breakdown and women's work-force participation have reduced opportunities for spontaneous informal contact that anchor elderly people in the community.
Stung by what happened over summer, the French Government intends tightening a civil code that spells out obligations for family care to ensure that children who have elderly parents living alone make it their business to keep in regular contact. While Opposition Leader Mark Latham urges Australian parents to make sure they know what their young 'uns are up to, the French are coercing middle-aged children to check on their old 'uns.
Elderly men are most vulnerable because they are not as good at plugging into community networks as women who have reared children and spent time building relationships with other mothers, teachers and suburban sporting clubs.
A report by the Australian Institute for Suicide Research and Prevention points out that living alone is not necessarily synonymous with social isolation. Women live longer than men, they are more likely to be widowed and living alone, yet they do not resort to suicide.
Triggers for depression among the elderly invariably involve feelings of loss. From relevance deprivation syndrome, which accompanies withdrawal from careers, to the loss of autonomy as people surrender their driver's licence and become dependent on others, the shrinking circles of engagement must be difficult to accept.
Recently I heard from a highly educated woman who mourned a lack of preparation for entering the seventh age. "No rite of passage. Perhaps that was my fault, not realising when younger and life is full how swiftly time does pass," she writes. "It is harder to see someone you love becoming frailer each day." Her husband was a surgeon who misses his contact with patients and their families. "Now he has to give up his voluntary work with preschool blind and deaf children, which was the highlight of his week."
According to John Snowden, a professor of psychiatry at the University of Sydney, general practitioners need to be alert to signs of depression in the elderly because 80 per cent of those who kill themselves visit a doctor within a three-week period before their death.
Luckily my friend's mother is all talk. Of course, that's half the cure.