Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-27T21:18:17.290Z Has data issue: false hasContentIssue false
  • English
  • Français

When elderly people give warning of suicide

Published online by Cambridge University Press:  26 March 2012

Ildri Kjølseth  and
Øivind Ekeberg
Ildri Kjølseth*
Affiliation:
RVTS, Oslo University Hospital, Aker, Oslo, Norway
Øivind Ekeberg
Affiliation:
Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway Department of Acute Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
*
Correspondence should be addressed to: Ildri Kjølseth, MD, PhD, RVTS, Oslo University Hospital, Aker, 0424 Oslo, Norway. Phone: +47 47653931; Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The study has a dual objective: (1) to investigate the extent to which, and how and to whom, elderly people gave warning (according to the definition of the term given by the American Association of Suicidology) prior to suicide; (2) to investigate how these warnings were perceived by the recipients of them, and what reactions the recipients had to the warnings.

Methods: This is a psychological autopsy study based on qualitative interviews. Sixty-three informants were interviewed about 23 suicides by individuals aged over 65 in Norway. The informants comprised relatives, general practitioners (GPs) and home-based care nurses. In general, the analysis of the interviews follows the systematic text condensation method.

Results: The interviews contained four main themes regarding reactions to the warnings: “not taken seriously,” “helplessness,” “exhaustion,” and “acceptance.” A total of 14 of the 23 elderly people gave warning before the suicides occurred. The warnings were given to relatives (11), home-based care nurses (5), and GPs (2).

Conclusions: Even though more than half of the elderly people had given warning (most frequently to relatives) before the suicide, the warnings did not initiate preventive measures. Together with passive attitudes, the lack of recognition of both the risk of suicide and the opportunities for treatment prevented possible measures being implemented. The paper discusses the grounds for the reactions as well as how suicide warnings given by elderly people can be taken seriously.

Keywords

agedpsychological autopsysuicide preventionqualitativesuicidal behavior
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 9 , September 2012 , pp. 1393 - 1401
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baltes, P. B. and Smith, J. (2003). New frontiers in the future of aging: from successful aging of the young old to the dilemmas of the fourth age. Gerontology, 49, 123–135.CrossRefGoogle Scholar
Beautrais, A. L. (2002). A case control study of suicide and attempted suicide in older adults. Suicide and Life-Threatening Behavior, 32, 1–9.CrossRefGoogle ScholarPubMed
Benazon, N. R. and Coyne, J. C. (2000). Living with a depressed spouse. Journal of Family Psychology, 14, 71–79.CrossRefGoogle ScholarPubMed
Beskow, J., Runeson, B. and Asgard, U. (1990). Psychological autopsies: methods and ethics. Suicide and Life-Threatening Behavior, 20, 307–323.CrossRefGoogle Scholar
Carney, S. S., Rich, C. L., Burke, P. A. and Fowler, R. C. (1994). Suicide over 60: the San Diego study. Journal of the American Geriatrics Society, 42, 174–180.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R., Cox, C., Herrmann, J., Forbes, N. and Caine, E. D. (1998). Age differences in behaviors leading to completed suicide. American Journal of Geriatric Psychiatry, 6, 122–126.CrossRefGoogle ScholarPubMed
Conwell, Y. et al. (2000). Completed suicide among older patients in primary care practices: a controlled study. Journal of the American Geriatrics Society, 48, 23–29.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R. and Caine, E. D. (2002). Risk factors for suicide in later life. Biological Psychiatry, 52, 193–204.CrossRefGoogle ScholarPubMed
Conwell, Y., Duberstein, P. R., Hirsch, J. K., Conner, K. R., Eberly, S. and Caine, E. D. (2010). Health status and suicide in the second half of life. International Journal of Geriatric Psychiatry, 25, 371–379.CrossRefGoogle ScholarPubMed
Duberstein, P. R., Conwell, Y. and Caine, E. D. (1994). Age differences in the personality characteristics of suicide completers: preliminary findings from a psychological autopsy study. Psychiatry, 57, 213–224.CrossRefGoogle ScholarPubMed
Duberstein, P. R. (2001). Are closed-minded people more open to the idea of killing themselves? Suicide and Life-Threatening Behavior, 31, 9–14.CrossRefGoogle Scholar
Harwood, D. M., Hawton, K., Hope, T. and Jacoby, R. (2000). Suicide in older people: mode of death, demographic factors, and medical contact before death. International Journal of Geriatric Psychiatry, 15, 736–743.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Harwood, D., Hawton, K., Hope, T. and Jacoby, R. (2001). Psychiatric disorder and personality factors associated with suicide in older people: a descriptive and case-control study. International Journal of Geriatric Psychiatry, 16, 155–165.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Heisel, M. J., Conwell, Y., Pisani, A. R. and Duberstein, P. R. (2011). Concordance of self- and proxy-reported suicide ideation in depressed adults 50 years of age or older. Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie, 56, 219–226.CrossRefGoogle ScholarPubMed
Jensma, F. (2010). Citizens Group Argues Right to Die. Available at: http://vorige.nrc.nl/international/Features/article2478619.ece/Citizens_group_argues_right_to_die; last accessed 8 February 2010.Google Scholar
Kjølseth, I., Ekeberg, Ø. and Steihaug, S. (2009). Why do they become vulnerable when faced with the challenges of old age? Elderly people who committed suicide, described by those who knew them. International Psychogeriatrics, 21, 903–912.CrossRefGoogle Scholar
Kjølseth, I., Ekeberg, Ø. and Steihaug, S. (2010a). Why suicide? Elderly people who committed suicide and their experience of life in the period before their death. International Psychogeriatrics, 22, 209–218.CrossRefGoogle ScholarPubMed
Kjolseth, I., Ekeberg, Ø. and Steihaug, S. (2010b). Elderly people who committed suicide:their contact with the health service. What did they expect, and what did they get? Aging and Mental Health, 14, 938–946.CrossRefGoogle ScholarPubMed
Kjølseth, I. (2010c). Control in Life-And in Death. An Understanding of Suicide Among the Elderly. Oslo: Faculty of medicine, University of Oslo.Google Scholar
Luoma, J. B., Martin, C. E. and Pearson, J. L. (2002). Contact with mental health and primary care providers before suicide: a review of the evidence. American Journal of Psychiatry, 159, 909–916.CrossRefGoogle ScholarPubMed
Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483–488.CrossRefGoogle ScholarPubMed
Malterud, K. (2002). Reflexivity and metapositions: strategies for appraisal of clinical evidence. Journal of Evaluation in Clinical Practice, 8, 121–126.CrossRefGoogle ScholarPubMed
Miller, M. (1978). Geriatric suicide: the Arizona study. Gerontologist, 18, 488–495.CrossRefGoogle ScholarPubMed
Owens, C., Lambert, H., Donovan, J. and Lloyd, K. R. (2005). A qualitative study of help seeking and primary care consultation prior to suicide. British Journal of General Practice, 55, 503–509.Google ScholarPubMed
Owens, C. et al. (2011). Recognising and responding to suicidal crisis within family and social networks: qualitative study. BMJ, Epublished ahead of print, doi: 10.1136/bmj.d5801.CrossRefGoogle ScholarPubMed
Pompili, M. (2010). Exploring the phenomenology of suicide. Suicide and Life-Threatening Behavior, 40, 234–244.CrossRefGoogle Scholar
Rubenowitz, E., Waern, M., Wilhelmson, K. and Allebeck, P. (2001). Life events and psychosocial factors in elderly suicides: a case-control study. Psychological Medicine, 31, 1193–1202.CrossRefGoogle ScholarPubMed
Rudd, M. D. (2008). Suicide warning signs in clinical practice. Current Psychiatry Reports, 10, 87–90.CrossRefGoogle ScholarPubMed
Rudd, M. D. et al. (2006). Warning signs for suicide: theory, research, and clinical applications. Suicide and Life-Threatening Behavior, 36, 255–262.CrossRefGoogle ScholarPubMed
Segal, D. L., Mincic, M. S., Coolidge, F. L. and O'Riley, A. (2004). Attitudes toward suicide and suicidal risk among younger and older persons. Death Studies, 28, 671–678.CrossRefGoogle ScholarPubMed
Uncapher, H. and Arean, P. A. (2000). Physicians are less willing to treat suicidal ideation in older patients. Journal of the American Geriatrics Society, 48, 188–192.CrossRefGoogle ScholarPubMed
Vannoy, S. D., Tai-Seale, M., Duberstein, P., Eaton, L. J. and Cook, M. A. (2011). Now what should I do? Primary care physicians' responses to older adults expressing thoughts of suicide. Journal of General Internal Medicine, 26, 1005–1011.CrossRefGoogle Scholar
Waern, M., Beskow, J., Runeson, B. and Skoog, I. (1999). Suicidal feelings in the last year of life in elderly people who commit suicide. Lancet, 354, 917–918.CrossRefGoogle ScholarPubMed
Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K. and Allebeck, P. (2002a). Burden of illness and suicide in elderly people: case-control study. BMJ, 324, 1355–1357.CrossRefGoogle ScholarPubMed
Waern, M. et al. (2002b). Mental disorder in elderly suicides: a case-control study. American Journal of Psychiatry, 159, 450–455.CrossRefGoogle ScholarPubMed