Abstract
Social disconnectedness in combination with depression, somatic disease, stigma, social exclusion and functional impairment has been described as a major risk factor for suicide in old age. However, protective factors have not been focused on in the same way. The aim was to identify psychosocial risk and protective factors in suicidal older persons. A systematic review was performed in Academic Search Premier (34), Ovid Medline (0), PsycInfo (0), PubMed (66), CINAHL (3) and ProQuest (1078) for the period May - September, 2014. Results: Twelve studies were included in the final analysis. Psychosocial risk factors were categorized under four themes: Being a burden to others increases depression and hopelessness, the struggle due to poor social integration, the strain of physical illness and old age and Negative aspects of religious activity. A total of four protective factors emerged: a sense of belonging, maintaining social dignity, satisfaction with relationships and feeling useful and positive aspects of religious activity. In conclusion, the context of a suicidal older person in a home healthcare service may create a “vulnerable psychosocial state” in which she/he is confronted by stressful psychosocial life events including physical illness and social network changes. The fact that protective factors are solely related to social factors needs to be taken into account in future prevention studies.
Highlights
The World Health Organization [1] reports that suicide in older adults is a global health problem
The psychosocial risk factors were categorized under four themes: Being a burden to others increases depression and hopelessness, The struggle due to poor social integration, The strain of physical illness and old age and Negative aspects of religious activity
Being a Burden to Others Increases Depression and Hopelessness One psychosocial risk factor was described as perceiving oneself as a burden to others, which increases depression and hopelessness [33] [40]
Summary
The World Health Organization [1] reports that suicide in older adults is a global health problem. Severinsson year age group has the highest suicide rate in most countries that report suicide statistics to the WHO [2]. Older adult suicidal behaviour is lethal, as nonfatal suicidal acts tend to be less common in this age group [3]. The available literature indicates various predictors of suicide in old age [6] [7] Stressful life events such as the loss of one’s spouse have been found to have a significant correlation with increased suicide risk in older adults [8]. Rurup et al [11] stated that the older persons in their study gradually developed suicidal ideation after a life full of adversity and as a consequence of ageing, illness or recurring depression. She/he must have a sense of thwarted belongingness, or lack of social connectedness through meaningful relationships [13]
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