A Desperate Act, Born of Depression

Posted on August 5, 2012

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When I lived in Miami it was common for  stories like this to make the news and that was back in the 1990s.  The fact is we don’t do a good job of taking care of providing psychological treatment for anyone in the United States.  As family we need to be more aware of how those we love  are dealing with the stresses that can come with significant illness, regardless of age.

In-home care can reduce the stresses felt by both the patient and the caregiver.  Call us at BrightStar if we can help.

This comes from the New York Times, August 3rd, and was written by Judith Graham.

Over the last several months, two California men have watched their wives end their lives after a long, drawn-out illness. Afterward, each of these old men was placed in handcuffs by the police, led from his home and questioned extensively, and faced the possibility of being charged with assisting in a suicide.

Were the husbands’ acts informed by love or despair? Were they a reasonable response to unbearable suffering?

Alan Purdy, 88, hadn’t been willing to accept his 84-year-old wife’s hopelessness in December, when he found her sitting in

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the garage of their home near San Diego with a car engine running. He pulled her out and revived her. But over the next several months, as Margaret Purdy complained to her husband and her children about unbearable pain from pancreatitis and three fractured vertebrae, Mr. Purdy had a change of heart.

In March, Mr. Purdy was at his wife’s side in their living room as she swallowed 30 sleeping pills, then wrapped a plastic bag around her neck and took her last breath. “Yes, I sat beside her as she died,” he told a reporter from The Los Angeles Times. “I didn’t want her to feel abandoned.”

San Diego prosecutors considered charging Mr. Purdy but have no immediate plans to do so, a spokeswoman told The New York Times.

In July, a similar story unfolded in Palm Springs when Lynda Bentinck disconnected her oxygen supply and asked her husband of 25 years not to resuscitate her. Mrs. Bentinck, 77, had terminal emphysema and was in hospice care at the time.

“The last few weeks, it had become unbearable for her,” Bill Bentinck, 87, told The Los Angeles Times, describing his wife’s breathing problems. “She’d wake up and say to herself, ‘Oh, my God, another day to go through like yesterday, only worse.’ And she wanted to end it all.”

Mrs. Bentinck had left a copy of her “do not resuscitate” order on a bedroom mirror. But because her husband waited several hours to call her hospice and had given her several shots of vodka that morning, police were suspicious and arrested him, confining him to a jail overnight.

He was released after Riverside County prosecutors decided not to pursue the case.

No one knows how often such cases occur; national data isn’t collected, according to Donna Cohen, a professor at the University of South Florida in Tampa who is an expert on suicides and murder-suicides in the elderly. She said only one spouse had been convicted of assisted suicide in the United States: a Manhattan resident, George Delury, who in 1995 admitted to helping his wife, Myrna Lebov, ingest a lethal dose of an antidepressant and later was found guilty of second-degree manslaughter. Ms. Lebov, 52, had lived for decades with multiple sclerosis.

Typically, older adults who find themselves in these kinds of circumstances are depressed, Dr. Cohen observed. Depression is the most common underlying cause of suicide in older people, and seniors take their lives more often than people in any other age group.

For Dr. Timothy Quill, a professor of medicine and psychiatry at the University of Rochester School of Medicine, the tragedy is that many older couples shut themselves off from others when their lives begin to spiral downward.

“If people could talk about this and didn’t have to go underground, we could help,” Dr. Quill said. “We have good ways of dealing with pain and depression.” He said he evaluates a lot of people who say they are contemplating suicide, “and for the vast majority, we’re able to help them find other alternatives.”

The key is finding out what the real issue is — why older people are suffering so much — and “then we can usually intervene to make their lives better” by offering palliative care, arranging for extra support or counseling, or other means, said Dr. Daniel P. Sulmasy, professor of medicine and ethics at the University of Chicago.

Often the underlying issue is not physical agony but unexpressed, unmet psychological or spiritual needs, he noted. For instance, for some people the sense that they are a burden to those they love is intolerable. For others, dependency, the loss of control or the prospect of being abandoned is excruciating. In these cases, reassuring people that they are loved, accepted and not alone can make an enormous difference, Dr. Sulmasy suggested.

“To me, this underscores that we as a society have not figured out how to help people who feel that desperate measures are indicated at the end of their lives or other critical junctures,” said Dr. Robert Brody, chief of the pain consultation clinic at San Francisco General Hospital.

What do you think? Is being present at a spouse’s suicide an act of love or an act of despair? Is the problem not enough help for older people in decline? Or are desperate acts sometimes a rational response to extraordinarily difficult circumstances?

You may also be interested in our series, Do you ask yourself, “How can I get through this?”

via A Desperate Act, Born of Depression – NYTimes.com.

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