In evaluating an elderly client at risk for suicide, which question should be asked first?

• A. Have you had suicidal thoughts in the past?
• B. How are you feeling today?
• C. Have you had thoughts of harming yourself?
• D. Do you have guns in your home?

Answer: (C)

Directly asking about suicidal thoughts establishes whether the person is currently at risk, which is the most critical information for safety. When someone is at risk, their immediate danger depends on whether they are having active thoughts, plans, or intent, and a direct question tends to elicit honest, specific responses that indirect questions may miss. Asking about past thoughts or how they feel in general today does not pin down present danger as clearly, and discussing access to firearms is important for safety planning but comes after identifying current ideation. If the person confirms thoughts of self-harm, you can then assess the plan, means, timing, and support, and take steps to ensure immediate safety and arrange appropriate care.