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“We always end up agreeing that the alternative is worse”, a sentence in common usage, but perhaps Helen Salisbury needs to improve her listening skills? The elderly are reputed to be more reticent about discussing suicidal ideation but have quite a high incidence of suicide. Many will have seen their GP recently before going ahead – some of the figures from the USA are particularly impressive. It would be interesting to know whether Dutch GPs see this as less of a no-go area and respond in the same way when discussing “the alternative” and whether both sides there feel easier about exploring the implications.
Although aware of these implications whilst working, it is only since joining the ranks of those perceived as elderly that I have learnt just how far how some of these comments could indeed be an opening gambit to a wider discussion. Similarly we need to think through why some elderly do not seek advice and help more routinely. I suspect many – probably more than we would like to admit to – do so for reasons of access, a feeling that they do not want to add to the burden of health care providers or to be processed into “care” (seen as protective custody) they do not want. It may be that they “have no need of our services” is not entirely true and when we judge the quality of the present services it should not only be based on those who use them.