Domenico and Gelsomina were the twin pillars of the close-knit Palmieri family.
The beloved grandparents would hold family dinners every Friday night in their Newcastle home, with stories and food from their homeland in Abruzzo, Italy.
"No matter what happened in our week we'd always come together here every Friday and that was happening as long as I could remember being around," granddaughter Sian Palmieri said.
Ms Palmieri remembered her grandfather, or Nonno, as a "gentle soul".
"My Nonno, everyone loved him, he was always smiling," she reminisced.
"He was always in the garden, [it] was his pride and joy."
The family was devastated when Mr Palmieri took his own life in January 2019, at the age of 84.
They discovered after his death that he had been planning it for some time.
"It just completely took us all by surprise, it was so out of the blue, so shocking," Ms Palmieri said.
"[It was] the worst experience really any family could go through."
Suicide among older people overlooked and ignored
Suicide among older people is a largely overlooked issue, despite the fact that suicide rates for older Australians are significantly higher than other age groups.
The most recent data from the Australian Bureau of Statistics shows the suicide rate of Australian men over 85 is more than three times the national average.
In 2020 and 2021, men aged between 80 and 84 also had the largest proportional increase in suicide rates, when accounting for demographic sizes.
Yet it is an issue that hardly gets a mention in policy-making, with the major focus on preventing suicide in younger Australians.
While that focus has been urgent and necessary, there are calls for older groups to be prioritised as well.
Anglicare runs what is believed to be the country's only national suicide prevention program for those working with, or caring for, older people.
Funded by the federal and NSW governments, the free, online Suicide Prevention for Seniors course is for anyone who has contact with older people including allied health workers, aged care workers and even financial planners.
Program manager Nancy Gewargis said the mental health of seniors was often dismissed.
"When society in general thinks about suicide, seniors are not top of mind," Ms Gewargis said.
She believes this is partly due to ageism.
"It's therapeutic nihilism, it's thinking that depression may be part of old age, that there's nothing that we can do to help an older person if they're going through thoughts of death and suicide," she said.
"Fifty per cent of residents in aged care homes are clinically depressed.
"But flip that around, 50 per cent are not. So we teach participants to act if they see the warning signs and have a conversation."
Ms Gewargis said grief and a sense of loss were some of the biggest risk factors.
"Grief not just about losing people, but about losing abilities. Losing what they once were able to do, maybe losing their home, having to move into an aged care home," she said.
"We can't reverse these things, but what we can do is help the person to cope with those changes and to cope with that grief."
Researching a neglected issue
Despite the high rates of suicide amongst older Australians, experts say the population has remained dramatically understudied.
Flinders University senior research fellow Monica Cations has attempted to shed light on the issue, compiling data looking at suicide amongst those aged over 65 who are either waiting for, or accessing, aged care services.
"We actually know quite little about older people who die by suicide. What are some of the risk factors for some of those deaths?" Dr Cations said.
Dr Cations found that more than 354 people in that group died by suicide between 2008 and 2017, and of those, only a small fraction were engaging with mental health services.
"Only about 20 per cent of people had accessed a Medicare-subsidised mental health care service [in the year before their death], which is a very low number given how these people eventually died," Dr Cations said.
"That tells us the importance of better understanding what are the barriers to older people accessing mental health care services? And what are the kinds of services that are going to be helpful in preventing death by suicide?"
While Dr Cations based her aged care research on the most recent overall data available to her, she said that more current figures could reflect stresses around COVID isolation, illness and cost of living increases.
"We don't have data about the period of the COVID-19 pandemic, or the period of the Royal Commission into Aged Care Quality and Safety and both these events were historical events that very likely had an impact on the mental health of older people accessing or waiting for aged care services," she said.
In 2022, Victoria recorded its highest number of annual suicides since the Coroners Court started collecting data in 2000.
The Victorian Suicide Register recorded a 9 per cent increase in suicides compared to the previous year.
This was in contrast to the preceding four years, which saw a plateau in suicide numbers in the state.
The most dramatic increase in Victoria last year was in those aged 65 years and older, with a 32 per cent increase from 2021 to 2022.
Older men most at-risk of suicide
While the largest number of suicides occur in men's middle years, the rate of suicide is highest among men aged over 85, according to Kylie King, a senior research fellow at the Turner Institute for Brain and Mental Health at Monash University.
In her research, Dr King said the men she spoke to often referred to being a burden to others as they aged.
Dr King said older men often didn't talk in terms of "suicide" and didn't have the language to express how they were feeling, making it hard for those around them to realise the risk of suicide.
"They spoke about wanting to choose the time and means of their death," she said.
"I think perhaps as a society, that sense of increased loss of purpose and worthlessness is sort of accepted as a normal part of ageing.
"But in fact, it's a major red flag for male suicide thinking amongst older men that we probably don't take as seriously as we should."
The latest ABS figures also show a slight increase in suicides in older women, but Dr King says it's too early to tell whether this is a trend.
The death of her beloved Nonno has driven Sian Palmieri to help other families avoid going through the same devastation, and she now works as a facilitator for the Suicide Prevention for Seniors program.
She believes it's time to start a national conversation around the issue, even though it is not an easy or comfortable topic to discuss.
"No one knows about it, no one talks about it," Ms Palmieri said.
"There's so much stigma around it, within the age and within culture, but I'm definitely so proud that our family decided we need to talk about it."
