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“Why do they become vulnerable when faced with the challenges of old age?” Elderly people who committed suicide, described by those who knew them

Published online by Cambridge University Press:  12 June 2009

Ildri Kjølseth*
Affiliation:
RVTS, Aker UHF, 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, RVTS, Oslo University Hospital, Aker, 0514 Oslo, Norway. Phone: +47 22029007. Email: ildri.kjolseth@medisin.uio.no.

Abstract

Background: Suicidal behavior among the elderly is a research field in which qualitative and quantitative methods can and should supplement each other. The objective of this qualitative study is to investigate whether the descriptions of elderly people who committed suicide, given by those who knew them, can provide common features that create recognizable patterns, and if so whether these patterns can help to shed light on the suicidal process.

Method: This is a psychological autopsy study based on qualitative interviews with 63 informants concerning 23 suicides committed by persons aged over 65 in Norway. The informants were relatives, their family doctors, and home-based care nurses. In general, the analysis of the interviews follows the systematic text condensation method.

Results: The descriptions have three main topics: life histories, personality traits and relationships. “Life histories” includes the sub-topics ability to survive and action-oriented achievers. They describe people who came through difficult circumstances when growing up and who were action-oriented in life in general and in crises. “Personality traits” includes the sub-topics obstinacy and controlling others. The informants saw the elderly people as strong-willed, obstinate and possessing a considerable ability to control themselves and those around them. “Relationships” includes the sub-topics I didn't know him and He showed no ability to meet us halfway, and describes the informants’ experience of emotionally closed persons who kept a distance in their relationships.

Conclusions: On the basis of the descriptions of the elderly people given in this study, we argue that these individuals will find difficulty in accepting and adapting to age-related loss of function since their self-esteem is so strongly associated with being productive and in control. Loss of control reveals their vulnerability – and this they cannot tolerate.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Baumeister, R. F. (1990). Suicide as escape from self. Psychological Review, 97, 90113.CrossRefGoogle Scholar
Beautrais, A. L. (2002). A case control study of suicide and attempted suicide in older adults. Suicide and Life-Threatening Behavior, 32, 19.CrossRefGoogle ScholarPubMed
Beskow, J., Runeson, B. and Asgard, U. (1990). Psychological autopsies: methods and ethics. Suicide and Life-Threatening Behavior, 20, 307323.CrossRefGoogle Scholar
Brandtstadter, J. and Renner, G. (1990). Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping. Psychology & Aging, 5, 5867.CrossRefGoogle ScholarPubMed
Clark, D. C. (1993). Narcissistic crisis of aging and suicidal despair. Suicide and Life-Threatening Behavior, 23, 2126.CrossRefGoogle ScholarPubMed
Cohler, B. J. and Jenuwine, M. J. (1995). Suicide, life course, and life story. International Psychogeriatrics, 7, 199219.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, 2329.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, 638647.CrossRefGoogle ScholarPubMed
Draper, B. et al. (2008). Long-term effects of childhood abuse on the quality of life and health of older people: results from the Depression and Early Prevention of Suicide in General Practice Project. Journal of the American Geriatrics Society, 56, 262271.CrossRefGoogle ScholarPubMed
Duberstein, P. R. (1995). Openness to experience and completed suicide across the second half of life. International Psychogeriatrics, 7, 183198.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, 213224.CrossRefGoogle ScholarPubMed
Duberstein, P. R., Conwell, Y. and Cox, C. (1998). Suicide in widowed persons. A psychological autopsy comparison of recently and remotely bereaved older subjects. American Journal of Geriatric Psychiatry, 6, 328334.CrossRefGoogle Scholar
Harwood, D. and Jacoby, R. (2000). Suicidal behaviour among the elderly. In Hawton, K. and van Heeringen, K. (eds.), The International Handbook of Suicide and Attempted Suicide (pp. 275291). Chichester: John Wiley & Sons Ltd.CrossRefGoogle Scholar
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, 155165.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Heckhausen, J. and Schulz, R. (1995). A life-span theory of control. Psychological Review, 102, 284304.CrossRefGoogle ScholarPubMed
Heckhausen, J. and Schulz, R. (1999). The primacy of primary control is a human universal: a reply to Gould's (1999) critique of the life-span theory of control. Psychological Review, 106, 605609.CrossRefGoogle ScholarPubMed
Heisel, M. J. (2006). Suicide and its prevention among older adults. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie, 51, 143154.CrossRefGoogle Scholar
Kjølseth, I. and Ekeberg, O. (1997). Suicide attempts among the elderly. Tidsskrift for Den Norske Laegeforening, 117, 39883991.Google ScholarPubMed
Kjølseth, I., Ekeberg, O. and Teige, B. (2002). Suicide among the elderly in Norway. Tidsskrift for Den Norske Laegeforening, 122, 14571461.Google ScholarPubMed
Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483488.CrossRefGoogle ScholarPubMed
Malterud, K. (2002). Reflexivity and metapositions: strategies for appraisal of clinical evidence. Journal of Evaluation in Clinical Practice, 8, 121126.CrossRefGoogle ScholarPubMed
Moore, S. L. (1997). A phenomenological study of meaning in life in suicidal older adults. Archives of Psychiatric Nursing, 11, 2936.CrossRefGoogle ScholarPubMed
Morling, B. and Evered, S. (2006). Secondary control reviewed and defined. Psychological Bulletin, 132, 269296.CrossRefGoogle ScholarPubMed
Pouliot, L. and De Leo, D. (2006). Critical issues in psychological autopsy studies. Suicide and Life-Threatening Behavior, 36, 491510.CrossRefGoogle ScholarPubMed
Rothbaum, F. and Weisz, J. (1982). Changing the world and changing the self: a two-process model of perceived control. Journal of Personality and Social Psychology, 42, 537.CrossRefGoogle Scholar
Rothermund, K. and Brandtstadter, J. (2003). Coping with deficits and losses in later life: from compensatory action to accommodation. Psychology and Aging, 18, 896905.CrossRefGoogle ScholarPubMed
Shah, A. (2007). The relationship between suicide rates and age: an analysis of multinational data from the World Health Organization. International Psychogeriatrics, 19, 11411152.CrossRefGoogle ScholarPubMed
Skinner, E. A. (1996). A guide to constructs of control. Journal of Personality and Social Psychology, 71, 549570.CrossRefGoogle ScholarPubMed
Smith, J. A. (2003). Qualitative Psychology: A Practical Guide to Research Methods. London: Sage.Google Scholar
Statistics Norway (2008). Dødsårsaker. Available at: http://www.ssb.no/dodsarsak/tab-2008–06-27–08.html.Google Scholar
Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K. and Allebeck, P. (2002). Burden of illness and suicide in elderly people: case-control study. BMJ, 324, 1355.CrossRefGoogle ScholarPubMed
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization.Google Scholar