Suicide And Death Ideation in Older Adults Obtaining Aging Services

Abstract

Objectives To assess the frequency and correlates of death and suicide ideation in older adults accessing aging services Design Cross-sectional Setting Data for this study were collected via in-home interviews. Participants ASN care management clients aged 60 years and older (N = 377) were recruited for this study. Measurement The PHQ-9 and the Paykel Suicide Scale were used to assess death and suicide ideation. Correlates of death and suicide ideation were also examined. Results Fourteen percent of subjects endorsed current death or suicide ideation, 27.9% of subjects endorsed death ideation in the past year, and 9.3% of subjects endorsed suicide ideation in the last year. Current death and suicide ideation were associated with greater depressive symptoms. As compared with individuals without ideation, individuals with death ideation demonstrated higher levels of depressive symptoms, more medical conditions, and lower social support. Individuals with suicide ideation demonstrated higher depressive and anxiety symptoms and less perceived social support. Finally, as compared with individuals with death ideation, individuals with suicide ideation demonstrated higher depressive and anxiety symptoms and more alcohol misuse. Conclusions Death and suicide ideation are common among ASN clients. There were both differences and similarities between correlates of death and suicide ideation. ASN providers are uniquely situated to address many of the correlates of suicide ideation identified in this study; however, in order to effectively manage suicide ideation in an ASN setting, links to primary and mental health care providers are necessary.

Issues in research on aging and suicide

“…Specifically, ASN organizations provide older adults access to services for nutrition, long-term care and supports, disease prevention, health promotion, and vulnerable elder rights protection. As we have discussed previously (O'Riley et al, 2014), the ASN is a key resource for late-life suicide prevention. Older adults accessing ASN services report high levels of psychological distress (Richardson, He, Podgorski, Tu, & Conwell, 2010), functional impairment and medical comorbidity (Richardson, Simning, He, & Conwell, 2011), as well as both active and passive suicide ideation (O'Riley, et al, 2014).…”

“…As we have discussed previously (O'Riley et al, 2014), the ASN is a key resource for late-life suicide prevention. Older adults accessing ASN services report high levels of psychological distress (Richardson, He, Podgorski, Tu, & Conwell, 2010), functional impairment and medical comorbidity (Richardson, Simning, He, & Conwell, 2011), as well as both active and passive suicide ideation (O'Riley, et al, 2014). Further, the ASN is designed and well-equipped to manage several risk factors for late-life suicide, including functional impairment and social isolation.…”

Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment

“…Most patients reported thoughts that life is not worth living (20%), and 23% (17/74) of the participants reported death (18%) or active suicidal ideation (5%). However, in addition to mild forms of suicidal ideation, our population manifested other independent suicide risk factors such as a diagnosis of major depression, cognitive impairment, disability, and increased medical burden, which elevate their suicide risk [34, 35] . Future investigations may examine whether elements of PATH could be re-purposed to decrease more prevalent wishes for death and thoughts of suicide by utilizing targeted emotion regulation techniques to reduce suicidal risk in high risk patients (e.g., patients with suicide intent, plan, or previous suicide attempts; or patients who were recently hospitalized).…”

Validation of telephone-based behavioral assessments in aging services clients

“…To highlight the BHL’s potential, we will use the ASN as a case example. Older adults at risk for suicide are unlikely to seek out help from traditional venues (Conwell and Thompson, 2008), and many older adults who seek ASN services experience thoughts of death and suicide (O’Riley et al , 2014), in addition to having high levels of anxiety and depression (Simning et al , 2010). This is especially pertinent since factors that may cause an older adult to seek help from a community-based provider such as an ASN agency (e.g., functional impairment, social isolation) are associated with an increased risk of completed suicide (Conwell et al , 2000; Fassberg et al , 2012).…”