When living gets tough: Depression and suicidal behavior in older adults with home care assistance or care in residential settings

Life weariness, death wishes and suicidal thoughts are more common in older adults who live in residential settings compared to their peers who live in the community.

Despite the fact that older adults are highlighted as a particular risk group in Sweden’s national plan for suicide prevention, the topic of suicidal behavior in residential settings has attracted relatively little research attention.

One explanation for this might be permissive attitudes to suicide in late life, which might in part reflect ageist societal attitudes.

The overarching goal of the proposed research is to fill knowledge gaps with regard to how suicidal feelings and behaviors develop in older adults in a) residential care or b) with home care assistance, and how work to improve mental health for older adults might be ifacilitated in these settings.Study questions include: a) what characterizes the development of depression and suicidality in older adults who reside in care settings/have home care assisstants? b) how can we learn from the experiences of relatives and care staff, when an older adult dies by suicide? c) what are the attitudes to suicide of care staff, and d) can we identify facilitators and barriers to suicide prevention?To answer these questions, we will utilize data from multiple sources including interviews with older adults who live in residential settings, relatives of persons who died by suicide, as well as staff who cared for these older adults prior to death.

Staff attitudes to suicide will be examined in a questionnaire study and barriers and facilitators of suicide prevention will be discussed in focus group meetings.Both quantitative and qualitative methods will be employed in our proposed research.

A multidisciplinary approach is needed to study the complex phenomenon of suicide and our group brings together competence spanning over psychiatry, nursing care, sociology, gerontology and geriatrics.