By Kelly Jones, MSN-Ed, RN, PHN, Program Director of GRHS’s Senior Life Solutions
“I’m ready to go.” Many family members, caregivers, health care professionals, and faith leaders have heard these words from an older adult. They may have also heard:
- “I just want to go home.”
- “Everyone would be better off without me.”
- “I want to go home to God.”
Statements like these may reflect exhaustion, grief, spiritual longing, fear, a wish for relief, thoughts of suicide, or several experiences at once. A caring and clinically responsible response begins by listening, asking what the person means, and assessing immediate safety.
A health care professional may move quickly to a suicide screening and safety plan. A family member may offer reassurance. A faith leader may speak about hope or purpose. Each response may come from a place of care. Understanding the meaning behind the person’s words helps guide what should happen next.
Why Older Adults Need Focused Attention
According to the Minnesota Department of Health’s 2024 data brief, Minnesotans ages 80 to 84 were one of the two age groups with the highest suicide rates in the state. Nationally, CDC data for 2024 identify adults ages 80 to 84 as having the highest suicide rate among age groups. Risk is especially high among older men. In 2021, men age 85 and older died by suicide at a rate of 55.7 per 100,000, nearly 17 times the rate among women of the same age.
Rural communities face additional concerns. In 2024, Minnesota counties classified as entirely rural had twice the suicide rate of Twin Cities metropolitan counties. Preliminary 2025 data continue to show the state’s highest suicide rates in entirely rural counties.
These statistics represent people whose experiences may receive less attention in public conversations about suicide prevention, including:
- An older adult grieving the death of a spouse
- A farmer struggling with the loss of physical ability
- A person whose chronic illness has narrowed daily life
- Someone who has stopped driving, attending church, or participating in activities that once provided connection and purpose
Suicidal distress can show up in many ways. Changes deserve particular attention when they are new, increasing, or connected to a painful event, loss, or major life transition. See the full list of warning signs in What Each of Us Can Do below.
Risk can be influenced by depression and other mental health conditions, serious illness, chronic pain, financial stress, relationship loss, hopelessness, social isolation, and access to lethal means. Suicide risk develops through a combination of individual, relationship, community, and societal factors.
Listen for Meaning and Ask Directly
Spiritual language deserves the same careful attention as any other statement about death.
Examples of Spiritual Language
- “I want to be with my husband.”
- “I want God to take me.”
A person may be expressing acceptance of natural death, a wish to reunite with someone who died, fear of prolonged suffering, depression, suicidal intent, or several of these experiences. A wish for natural death and an intention to cause death are distinct clinical experiences. Direct and respectful questions help clarify what the person is experiencing.
Begin by Asking
- “What does going home to God mean to you?”
- “What feels hardest for you right now?”
Ask Directly About Suicide
- “Are you thinking about suicide?”
- “Have you thought about how you might do it?”
- “Do you have access to what you would use?”
- “Do you think you may act on these thoughts today or soon?”
Research supports direct questions about suicide as a way to identify risk and open an honest conversation. A trained clinician can continue with a fuller assessment of suicidal thoughts, intent, plan, access to lethal means, timing, previous behavior, and protective factors.
Ask About the Person’s Experience
- “What has changed recently?”
- “What feels unbearable today?”
- “What are you most afraid will happen?”
- “Do you feel like a burden?”
- “What would help you feel more in control?”
- “Who helps you feel connected?”
- “Would you like support from a faith leader or chaplain?”
These questions help clinicians, caregivers, and other supporters understand the person’s pain, fears, values, relationships, and sources of strength. They also help identify the support that may be needed after the immediate crisis has passed.
Protect Safety and Preserve Agency
Older adults may already have experienced significant changes in where they live, how they travel, who assists with personal care, how they spend their time, and how medical decisions are made.
A crisis response may introduce unfamiliar professionals, changes to the person’s environment, removal of belongings, an emergency evaluation, or hospitalization. These steps may be necessary to address immediate risk. Clear explanations and respectful communication can help preserve dignity and agency throughout the process.
Explain what is happening and why. Tell the person what will happen next. Offer choices when they are available. Involve trusted family members, caregivers, clergy, or other supports with the person’s permission and within applicable privacy requirements. Use the least restrictive approach that can safely address the immediate risk.
An active suicide plan, access to lethal means, preparatory behavior, a recent attempt, or intent to act warrants urgent intervention at every age and stage of illness.
Compassionate Language May Sound Like
- “I hear how exhausted you feel.”
- “Your safety matters, and I am going to stay with you while we connect with help.”
- “I will explain each next step and include you in decisions whenever possible.”
Validation communicates that the person has been heard. Safety planning communicates that support is available and that others will remain present during the crisis.
Build a Community Response
Behavioral health treatment may include therapy, medication management, safety planning, crisis services, emergency evaluation, or hospitalization, depending on the person’s needs. Older adults, however, may first share their distress outside a clinical setting. They may tell a nurse, home health aide, pastor, priest, hospice chaplain, senior center employee, hairstylist, meal-delivery volunteer, neighbor, or friend — each one a possible connection to care.
Faith communities can be valuable partners, especially for older adults with established congregational relationships to help people find hope and meaning. They can offer transportation, meals, spiritual guidance, and the kind of regular contact that notices when someone is absent. Faith leaders can also ask direct questions about suicide, help connect someone to crisis or behavioral health services, and stay involved after the immediate crisis passes.
Coordination among behavioral health providers, primary care teams, family members, aging services, hospice professionals, and spiritual supports can provide continuity. With the person’s consent and within privacy requirements, members of this support network can clarify who will follow up, who will assist with appointments, and who will remain available during periods of increased distress.
What Each of Us Can Do
- Notice changes and respond. Take new or increasing statements about death seriously. Pay attention to:
- Withdrawal
- Giving away possessions
- Changes in self-care
- Increased hopelessness
- Loss of interest in relationships and activities
- Ask directly. Use the word “suicide.” A clear question gives the person an opportunity to answer honestly. See the sample questions in Listen for Meaning and Ask Directly above.
- Listen for the source of distress. Ask about:
- Grief, pain, or illness
- Fear or loss of independence
- Financial pressure
- Loneliness or loss of purpose
- Feeling like a burden
- Spiritual concerns
- Support immediate safety. Remain with the person when there is an immediate concern. Reduce access to firearms, medications, or other lethal means when this can be done safely. Contact 988, emergency services, or a qualified health care professional based on the level of risk. Reducing access to lethal means and connecting the person with support are established suicide-prevention steps.
- Continue the connection. Hospital discharge, a return home, hospice enrollment, or an initial appointment may be one step in a longer period of support. Continue to call, visit, and ask how the person is doing. Help arrange transportation, appointments, meals, or time with trusted people. Follow-up is an important part of suicide prevention.
Responding With Safety, Dignity and Connection
Older adult suicide prevention begins with taking suffering seriously.
Some losses cannot be repaired. Chronic illness, disability, and changes in independence may continue to shape daily life. Care can address treatable symptoms, strengthen connection, preserve choices where possible, and help the person feel supported through difficult circumstances.
When an older adult says, “I’m ready to go,” listen closely and respond with the safety, dignity, and connection described above.
Safety, connection, and respect belong in the same response. Together, they are central to suicide prevention.
Get Help During a Mental Health Crisis
If you or someone you know is experiencing a suicidal or mental health crisis, call or text 988 to reach the Suicide & Crisis Lifeline. In an immediate life-threatening emergency, call 911.
About Senior Life Solutions
Senior Life Solutions is an outpatient mental health program designed to meet the unique needs of older adults experiencing depression, anxiety, grief, loneliness, difficulty adjusting to health changes, or other emotional challenges. For more information about Senior Life Solutions at Glacial Ridge Health System, call 320-331-2107.
RELATED ARTICLES:
The Four Key Parts of Healthy Aging – and How to Strengthen Each One
How Falls, Loss, and Life Changes Can Trigger PTSD in Older Adults