Shadows From the Past
The Situated Meaning of Being Suicidal Among Depressed Older People Living in the Community
Abstract
Background: Most depressed older people in a suicidal state have mixed feelings, where the wish to live and the wish to die wage a battle. Aims: To explore and describe depressed older people’s experiences of being suicidal and their search for meaning. Method: Data were collected from 29 participants resident in the Rogaland and Vestfold districts of Norway, by means of individual interviews, after which a thematic analysis was performed. Results: For the participants in this study, the lived experiences of the situated meaning of survival after being suicidal comprised a main theme – ”shadows from the past” – and two themes – ”feeling that something inside is broken” and ”a struggle to catch the light.” Conclusion: Mental health-care professionals might be able to reduce the risk of suicide and perturbation by helping depressed older people to explore, resolve, and ultimately come to terms with their unresolved historical issues. Additional valuable strategies in primary care settings include encountering patients frequently, monitoring adherence to care plans, and providing support to address the source of emotional pain and distress.
References
(1974). A hundred cases of suicide: Clinical aspects. British Journal of Psychiatry, 125, 355–373.
. (2006). US injury mortality statistics. Retrieved from www.cdc.gov/ncipc/factsheets/suifacts.htm
(2012). The effects of reminiscence therapy on depressive symptoms of Chinese elderly: Study protocol of a randomized controlled trial. BMC Psychiatry, 12, 189.
(2011). Suicide in older adults. Psychiatric Clinics of North America, 34(2), 451–458.
(2008). Suicidal behavior in elders. Psychiatric Clinics of North America, 31, 333–356.
(2003). Research endeavours into suicide: A need to shift the emphasis. Mental Health Nursing, 12(2), 92–99.
(2009). Suicide survivors and the suicidology academe. Reconciliation and reciprocity. Crisis, 30(4), 208–214.
(2004). Suicide and suicidal behaviour in late life. In , Suicidal behaviour: Theories and research findings (pp. 253–286). Ashland, OH: Hogrefe & Huber.
(2011). Suicide of elderly persons: Towards a framework for prevention. Geriatric Gerontology International, 11, 107–113.
(1994). Introduction: Entering the field of qualitative enquiry. In , Handbook of qualitative research (pp. 1–14). London, UK: Sage.
(2000). The concept of theme as used in qualitative nursing research. Western Journal of Nursing Research, 22, 351–372.
(2004). Loss of partner and suicide risks among oldest old: A population-based register study. Age Ageing, 33, 378–383.
(2004). Truth and method. Gloucester, UK: Interactive Sciences Ltd.
(2011). Revitalizing worthiness: A theory of overcoming suicidality. Grounded Theory Review, 10(2), 21–44.
(2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.
(2007). Clinical management of suicidality in the elderly: An opportunity for involvement in the lives of older patients. Canadian Journal of Psychiatry, 52, 47–58.
(2005). Recall bias can be a threat to retrospective and prospective research designs. The Internet Journal of Epidemiology, 3(2). Retrieved from ispub.com/IJE/3/2/13060
(2009). The meaning of emotional pain. Analytic interpretative research on women’s experiences of mental health problems (Doctoral dissertation). Faculty of Social Sciences, Stavanger, Norway: University of Stavanger.
(2009). Emotional pain: Surviving mental health problems related to childhood experiences. Journal of Psychiatric and Mental Health Nursing, 16, 636–645.
(2009). Longing for reconciliation: A challenge for women with borderline personality disorder. Issues in Mental Health Nursing, 30, 560–566.
(2008). The emotional pain and distress of borderline personality disorder. A review of the literature. International Journal of Mental Health Nursing, 17(1), 27–35.
(2010). Desire to survive emotional pain related to self-harm: A Norwegian hermeneutic study. Nursing and Health Sciences, 12(1), 52–57.
(1963). Memories, dreams, reflections (). London, UK: Collins.
(2010).Why suicide? Elderly people who committed suicide and their experience of life in the period before their death. International Psychogeriatrics, 22(2), 209–218.
(2011). A systematic review of elderly suicide prevention programs. Crisis, 32, 88–98.
(1985). Naturalistic inquiry. London, UK: Sage Publications Inc.
(1963). The existential background of human dignity. Cambridge, MA: Harvard University Press.
(1997). Review of suicidology. New York, NY: Guilford.
(2001). A model of consolation. Nursing Ethics, 8, 544–553.
(2007). Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin, 54, 306–369.
. (2003). Ethical guidelines for nursing research in the Nordic countries. Retrieved from www.sykepleien.no/ikbViewer/Content/337889/SSNs%20etiske%20retningslinjer.pdf
(2004). Recent developments: Suicide in older people. BMJ, 329(7471), 895–899.
(2010). Essentials of nursing research: Appraising evidence for nursing practice. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
(1959). Some clinical considerations in the prevention of suicide based on a story of a 134 successful suicides. American Journal of Public Health, 49, 888–899.
(2011). Understanding why older people develop a wish to die. A qualitative interview study. Crisis, 32(4), 204–216.
(1998). The call to experts in qualitative research. Research in Nursing and Health, 21, 467–471.
(2013). Suicide: Towards a clinical portrait. In , Routledge international handbook of clinical suicide research (pp. 249–258). London, UK: Routledge, Taylor and Francis.
(2007). The relationship between suicide rates and age: An analysis of multinational data from the World Health Organization International. International Psychogeriatrics, 19, 1141–1152.
(1998). Perspectives on suicidology. Further reflections on suicide and psychache. Suicide & Life-Threatening Behavior, 29(4), 287–294.
(2003). . Nursing Ethics, 10(6), 614–623.
(2001). Återhämtning från svåra psykiska störningar [Recovery from mental health illnesses]. Stockholm, Sweden: Bokförlaget Natur och Kultur.
(2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408.
(1997). Childhood abuse and neglect and loss of self-regulation. Bulletin of the Menninger Clinic, 58(2), 145–163.
(2002). Mental disorder in elderly suicides. American Journal of Psychiatry, 159, 450–455.
(2007). Psychotherapeutic strategies for healing trauma. Perspectives in Psychiatric Care, 43(3), 132–141.
. (2002). Suicide prevention in Europe: The WHO European monitoring survey on national suicide prevention programs and strategies. Retrieved from search.who.int/search?q=suicde%2C+elderly&ie=utf8&site=default_collection&client=_en&proxystylesheet=_en&output=xml_no_dtd&oe=utf8
. (2012). Depression is a common illness and people suffering from depression need support and treatment. Retrieved from www.who.int/mediacentre/news/notes/2012/mental_health_day_20121009/en/
(2011). Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans. Journal of Clinical Nursing, 15–16, 2195–21203.
(1995). The alienation of the sufferer. Advanced Nursing Science, 17(4), 53–72.
(2011). The effects of group reminiscence therapy on depression, self-esteem, and affect balance of Chinese community-dwelling elderly. Archives of Gerontology Geriatric, 54(3), 440–447.
