SUPPORTING OLDER VETERANS WITH SUICIDAL SYMPTOMOLOGY AND THEIR CAREGIVERS WITH A NOVEL TREATMENT

Abstract

Introduction Older Veterans are the largest and fastest growing segment of the Veteran population. In a report published by the Veterans Affairs (VA), the rate of depression is doubled in Veterans aged ≥65 years as compared to the general population within the same age group (VHA Report, 2015). Additionally, the rates of suicide completion are highest in older Veterans; 68% of all deaths by suicide are in Veterans that are 50 and older (VA National Suicide Data Report, 2005-2015, 2018). Despite their elevated risk, there is limited research and fewer interventions targeting suicide and suicidal behavior in older Veterans. Methods Creating a Suicide Safety Plan (SSP) is an effective treatment for Veterans with suicidal ideation and can decrease suicidal behaviors (Miller et al., 2017; Stanley et al., 2016). Due to the deaths of spouses and friends, many older adults do not have a strong social network and very few whom they would turn to in a suicidal crisis. Therefore, increasing communication between the existing social supports and increasing the usage of the Safety Plan would be possibly life-saving to older Veterans. Additionally, it could also reduce caregiver burden that may exist in the existing social supports. A current randomized clinical trial titled Safe Actions for Families to Encourage Recovery (SAFER), a novel, 4-session manualized family-based intervention being conducted at the James J. Peters VA Medical Center, focuses on implementing the SSP in Veterans at moderate-risk for suicide. Using psychoeducation and disclosure, SAFER provides the structure to support caregiver involvement in suicide safety planning with the development and revision of both the Veteran and a complementary family member safety plan. Please see Table 1. Results The current SAFER sample only includes five individuals 65 and older (total sample average: 56.53 years). Reviewing preliminary data from the Beck Scale for Suicidal Ideation suggests that those over the age of 65 experienced almost twice as much ideation (M=25.33, SD=9.45) as compared to those under 65 (M=13.61, SD=9.54). An independent samples T-test was performed to further explore this relation suggesting that even in this small sample the difference in scores was approaching significance t(24)= -2.003, p=.057. These initial findings conceptualize a need for research and treatment targeting the geriatric population. To target the moderate-risk and high-risk geriatric population, our research team is developing ways to adapt SAFER. In adapting SAFER for older adults, accommodations will be made for potential hearing and vision impairments as well as limitations in attention spans among older adults who may have mild deficits in working memory and short-term memory. Additionally, modifications will also need to be made for the caregivers of older adults, such as co-morbidities or possible memory loss of the older adult. Please see Table 2 for existing SAFER session outline. Full data set to be included in final presentation. Conclusions Many elderly adults experience challenges, such as retirement, loss of spouse or close friends, depreciated physical capabilities, survivor guilt, unresolved grief, and limited social support (Rose, 2017). These challenges can be a trigger for suicidal symptoms; therefore, more research and interventions should target suicide and suicidal behavior in older Veterans. One significant limitation to the ongoing study is the lack of representation of geriatric patients; therefore, a future direction of SAFER is to have modules focusing the geriatric population This research was funded by This research was supported by VA Merit Award (1I01RX002432-01) and the VISN 2 South MIRECC. PDF: http://submissions.mirasmart.com/Verify/AAGP2019/Original/AAGP2019-000446/AAGP2019-000446_Fig1.pdf PDF: http://submissions.mirasmart.com/Verify/AAGP2019/Original/AAGP2019-000446/AAGP2019-000446_Fig2.pdf