Dear Family Advisor

I'm afraid my husband, who has a terminal disease, is suicidal

Last updated: Oct 17, 2009

My husband has liver cancer, and the doctors have given him less than a year to live. He's completely given up hope. I came home from shopping to find a giant hole in our wall. He said he was cleaning his gun and it accidentally went off. I'm not sure I believe him. I live in constant fear. I know he's in pain and hates chemo, but I don't want this to be the family legacy he leaves behind. His children would be devastated.

What do I say or do to convince him that suicide would be awful for those who love him?

I'm so sorry that you and your husband are going through this. I know you're scared and worried. Reaching out for guidance is the best thing you can do.

Suicide among older adults is much more common than we'd like to think. In fact, the suicide rate of older men is three times higher than that of younger people, according to the 2001 U.S. statistics for elder suicide. One of the main reasons it happens is that we don't like to talk about it. We don't want to confront someone we love with such a painful concern. But you need to face your fears, and getting them out in the open is the first step.

It's time for you two to have a very honest talk. Ask your husband to listen, really listen, and then share your heart. Tell him you think he might be having suicidal thoughts. Don't sound accusatory. If he starts to argue or become defensive, ask him again to simply listen --- and explain that you deserve that as his wife.

Tell him you understand what he's up against -- the cancer, the chemo, the pain -- but that suicide is not an option. Be extremely clear that suicide is very, very hard on the family members left behind, and while he may consider this a way out of his pain, he'd actually cause immense pain for his children and you. The effect of suicide also ripples throughout a family's community. It causes doubt and sorrow to spread like the cancer he's fighting.

Ask him to not do this and to seek help with you instead. Tell him you'll do everything you can to help him find new medications for the pain and to find a way to handle his thoughts. Assure him that while you know it won't be easy, you need him to live the last stage of his life with dignity and grace, and that you'll be there, as his wife, no matter what.

If he's worried that he's a burden to you and others, tell him that that's not the case -- that he's your husband in sickness and in health and you love him.

If you haven't engaged hospice, I recommend that you do. They can help manage his pain and assist both of you with end-of-life concerns. You'll have access to nurses, palliative care, a social worker, and a chaplain. They'll have a list of the best doctors and therapists who work with families facing just what you're facing. Many hospices also have caregivers' groups and community resources to support you.

I would also remove the gun(s) from the house. Not that he couldn't try to harm himself with something else, but he obviously has a connection to guns, so it's wise to remove them, one less temptation.

Even after all this, I can't promise how things will turn out. You can't necessarily "fix" this situation or stop your husband from harming himself. Your husband is in pain. He knows his cancer is incurable. He feels isolated, and he's most likely clinically depressed. Isolation is one of the major factors of suicide and depression.

As awful as it is to bring up, I have to ask you to consider that your life could be in danger as well. Many people get into the mind-set that it would be better to "go out together." I'm not trying to scare you, but I need you to consider your safety. That's why you have to reach out to others -- as soon as you can. Talk to a trusted friend, a counselor, or a chaplain about you. You need professional advice (and a professional ear) to get through this.

I'm recommending some useful links below, but don't try to navigate these tough waters just by surfing the Web. Your mental health and well being are at risk as well, especially if you try to go it alone. As much as we love our spouses, we must separate ourselves enough to stay well and whole. If we don't, we can fall into the same dark hole.

I hope that you and your husband can spend the last months, weeks, and days together, and that it will be a time of peace and healing. That's why it's so important that you don't ignore or deny what's happening. Make noise, call out for help, move quickly, and surround yourself with people who care.

Helpful resources about elder suicide: