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Why suicide? Elderly people who committed suicide and their experience of life in the period before their death

Published online by Cambridge University Press:  14 September 2009

Ildri Kjølseth ,
Øivind Ekeberg  and
Sissel Steihaug
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, Norway
Sissel Steihaug
Affiliation:
SINTEF, Health Services Research, Blindern, Oslo and Helse Sør-Øst Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
*
Correspondence should be addressed to: Ildri Kjølseth, MD, RVTS, Oslo University Hospital, Aker, 0514 Oslo, Norway. Phone: +47 22029007. Email: [email protected].
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Abstract

Background: The objective of this study is to acquire an understanding of the suicides among a group of elderly people by studying how they experienced their existence towards the end of life.

Methods: This is a psychological autopsy study based on qualitative interviews with 63 informants in relation to 23 suicides committed by persons aged over 65 in Norway. Informants who knew the deceased persons well describe what the elderly person communicated to them about their experience of life in the period before the suicide and how they as informants saw and understood this. The informants comprise relatives, family doctors and home-based care nurses. The analysis of the interviews follows the systematic text condensation method.

Results: The descriptions are divided into three main elements: the elderly persons' experiences of life, their perception of themselves, and their conceptions of death. “Experience of life” has two sub-topics: this life has been lived and life as a burden. Everything that had given value to their life had been lost and life was increasingly experienced as a burden. Their “perception of themselves” concerned losing oneself. Functional decline meant that they no longer had freedom of action and self-determination. “Conceptions of death” involve the following sub-topics: acknowledgement/acceptance and death is better than life. Life had entered into its final phase, and they seemed to accept death. For some time, many of them had expressed the wish to die.

Conclusions: The results lead us to argue that their suicides should be considered as existential choices. The sum total of the different forms of strain had made life a burden they could no longer bear. Age meant that they were in a phase of life that entailed closeness to death, which they could also see as a relief.

Keywords

suicideagedqualitative researchpsychological autopsy
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 2 , March 2010 , pp. 209 - 218
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Battin, M. P. (1999). Can suicide be rational? Yes, sometimes. In Werth, J. L. (ed.), Contemporary Perspectives on Rational Suicide (pp. 13–22). Philadelphia: Taylor & Francis.Google Scholar
Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97, 90–113.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
Beskow, J., Runeson, B. and Asgard, U. (1990). Psychological autopsies: methods and ethics. Suicide and Life-Threatening Behavior, 20, 307–323.CrossRefGoogle Scholar
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
Crocker, L., Clare, L. and Evans, K. (2006). Giving up or finding a solution? The experience of attempted suicide in later life. Aging and Mental Health, 10, 638–647.CrossRefGoogle ScholarPubMed
de Beauvoir, S. (1948). The Ethics of Ambiguity. New York: The Citadel Press.Google Scholar
Grøn, A. (1993). Begrebet Angst hos Søren Kierkegaard. Copenhagen: Nordisk Forlag A.S.Google Scholar
Hallberg, I. R. (2004). Death and dying from old people's point of view: a literature review. Aging: Clinical and Experimental Research, 16, 87–103.Google 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
Kjølseth, I., Ekeberg, Ø. and Sissel 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. E-published ahead of print, doi: 10.1017/S1041610209990342.CrossRefGoogle Scholar
Lakeman, R. and FitzGerald, M. (2008). How people live with or get over being suicidal: a review of qualitative studies. Journal of Advanced Nursing, 64, 114–126.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M., Kennedy, V., Sixsmith, A. and Sixsmith, J. (2007). The end of life: a qualitative study of the perceptions of people over the age of 80 on issues surrounding death and dying. Journal of Pain and Symptom Management, 34, 60–66.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
Marino, G. D. (1998). Anxiety in the concept of anxiety. In Hannay, A. and Marino, G. D. (eds.), The Cambridge Companion to Kierkegaard (pp. 308–328). Cambridge: Cambridge University Press.Google Scholar
Moore, S. L. (1997). A phenomenological study of meaning in life in suicidal older adults. Archives of Psychiatric Nursing, 11, 29–36.CrossRefGoogle ScholarPubMed
Morse, J. M. (2001). Using shadowed data. Qualitative Health Research, 11, 291–292.CrossRefGoogle ScholarPubMed
Neimeyer, R. A. (2000). Series foreword. In Tomer, A. (ed.), Death Attitudes and the Older Adult (pp. vii–viii). Philadelphia: Taylor & Francis.Google Scholar
Smith, J. A. (2003). Qualitative Psychology: A Practical Guide to Research Methods. London: Sage.Google Scholar
Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K. and Allebeck, P. (2002a). Burden of illness and suicide in elderly people: a case-control study. BMJ, 324, 1355–1357.CrossRefGoogle Scholar
Waern, M. et al. (2002b). Mental disorder in elderly suicides: a case-control study. American Journal of Psychiatry, 159, 450–455.CrossRefGoogle ScholarPubMed
Werth, J. L. (1996). Rational Suicide? Implications for Mental Health Professionals. Washington: Taylor & Francis.Google Scholar
Williams, M. (2001). Suicide and Attempted Suicide. London: Penguin Group.Google Scholar
Wulff, H. R., Pedersen, S. A. and Rosenberg, R. (1990). Philosophy of Medicine. Oxford: Blackwell Scientific Publications.Google Scholar
Yalom, I. D. (1980). Existential Psychotherapy. New York City: Basic Books.Google Scholar