State’s rate of 32 deaths per 100,000 residents 65 and older is “very concerning,” says executive of the foundation that published the report.

Jerome Penaranda with his mother, Vivian Penaranda, on Mother's Day in 2015 in Las Vegas (Family photo courtesy of Jerome Penaranda).

Left to right: Jerome Penaranda, his father, Roberto, sister, Jasmin Briggs, and mother, Vivian Penaranda in 1986 (Family photo courtesy of Jerome Penaranda).

Jerome Penaranda, right, with his nephew, Jordan, sister, Jasmin Briggs, and mother, Vivian Penaranda, on Mother's Day in 2017 (Family photo courtesy of Jerome Penaranda).

Jerome Penaranda with his mother, Vivian Penaranda, on Mother's Day in 2015 in Las Vegas (Family photo courtesy of Jerome Penaranda).

Sundays for Jerome Penaranda meant “mom time” with his 66-year-old mother, Vivian — an afternoon church service followed by traditional Filipino cuisine at Goldilocks bakery in Las Vegas.

So when she didn’t call as usual around 1 p.m. on Sunday, June 25, 2017 — right after her Zumba class — he wondered if something was wrong.

The horrifying answer arrived in the early hours of Monday, when Vivian Penaranda, 66, was found dead in her apartment. The window cracks were covered with pieces of cloth; prescription medications lined a table.

A brief note offered Jerome and his sister an apology and asked Jesus for forgiveness for taking her own life.

Vivian Penaranda was one of nearly 90 people 65 and older who committed suicide in Clark County last year, according to the coroner’s office. That played a big role in making Nevada the state with the highest suicide rate among seniors in the nation, according to a report published Thursday.

Lack of connectedness

About 32 of every 100,000 Nevadans over 65 die from suicide, according to a new report by the United Health Foundation. That’s nearly double the average U.S. suicide rate among seniors and up from the state’s rate of 29.6 per 100,000 in 2017.

Nevada’s last-in-the-nation ranking, a position it has held in four of the five years the foundation has studied suicide rate, is “very concerning,” said Dr. Rhonda Randall, the foundation’s chief medical officer and executive vice president for UnitedHealthcare Retiree Solutions.

One reason for that, she said, is that the report raises more questions than it answers. While suicide is often correlated to frequent mental distress, multiple chronic health conditions and excessive drinking and substance use, Nevada ranks near the middle of the pack in many of those categories.

Richard Egan, suicide prevention training and outreach facilitator for the state’s Office of Suicide Prevention, attributes high rates of suicide to the lack of a feeling of connectedness.

“It’s something we’ve been working on for years,” Egan said. “We always talk about how we can address it, and the thing that we address it with, especially with out elderly, is connectedness: connectedness in family, in communities, in a neighborhood.”

Thursday’s report does contain clues that suggest a lack of community involvement might be an issue. The report measures involvement in volunteer work, for example, which Randall said can point to how actively a person participates in their community.

On that measure, Nevada came in last.

Warning signs

Apart from her weekly visits with her son, Vivian Penaranda largely kept to herself. She lived on her own and kept secrets from her family. Jerome Penaranda said he wasn’t aware of the severity of his mother’s medical conditions, including diabetes and heart problems, until he saw the prescription bottles piling up in her home.

Penaranda said he wishes he’d noticed the warning signs while there was time to intervene. Once in a while, his mom asked for information about life insurance, or said she was depressed. He thinks she worried about burdening him and his sister — a common concern among elderly people with suicidal tendencies, Egan said.

It’s also common for relatives to miss signals that a loved one might be considering ending his or her life, he said. Among the elderly, losing a sense of identity or involvement in family or community are common warning signs. Others include talk or writing indicating hopelessness, a fixation on death, threats to inflict self harm or raw emotions like rage and anxiety. Mood disorders, substance abuse, prior suicide attempts and access to lethal means also are major risk factors, he said.

“It all comes down to a person acting maladaptive or out of character for themselves,” Egan said.

Anyone concerned that a person might be considering ending their life should call the National Suicide Prevention Lifeline at 1-800-273-TALK or reach out to local police.

In her memory

For Penaranda, there will never be enough time to get over the loss of his mother. He reminds his friends now to spend more time with their older loved ones and show them they’re a priority, he said.

Before his mother’s death, Penaranda planned to take her on a vacation to the Philippines, her birth country, after she retired from her cashier job at Excalibur. It would’ve been a retirement gift.

Instead, he tattooed his arm in her memory.

“It says, ‘I can do all things through Christ, who strengthens me,’” Penaranda said. “It’s just a reminder to stay strong, believe in God and just know that she’s up there in a better place.”

Contact Jessie Bekker at jbekker@reviewjournal.com or 702-380-4563. Follow @jessiebekks on Twitter.