HIGHLIGHTS
- •What is the primary question addressed by this study?What are the subjective experiences of older adults who have died by suicide at the time proximal to their death?
- •What is the main finding of this study?We explored the subjective experiences of older adults who have died by suicide through the qualitative analysis of suicide notes. Through these notes, older adults describe feelings of burdensomeness, loneliness, and hopelessness related to mental and physical illness.
- •What is the meaning of the finding?This study can help in the development of targeted interventions for mitigating suicide risk in older adults by understanding the explanatory narratives contributing to suicide-related thoughts and behaviors in this highly vulnerable subset of those experiencing suicidal ideation.
Abstract
Objective
Suicide is a complex multifactorial process influenced by a variety of biological,
psychological, and social stressors. Many older adults face a characteristic set of
challenges that predispose them to suicidal ideation, suicide-related behavior, and
death by suicide. This study explored the subjective experience of suicidality through
the analysis of suicide notes from older adults.
Design
Qualitative study analyzing written suicide notes.
Setting
Written notes for suicide deaths in Toronto, Canada, between 2003 and 2009 were obtained
from the Office of the Chief Coroner for Ontario.
Participants
The analysis comprised 29 suicide notes (mean words per note: 221; range: 6–1095)
written by individuals 65 years and older (mean ± SD age: 76.2 ± 8.3).
Measurements
We employed a constructivist grounded theory framework for the analysis, conducted
through line-by-line open coding, axial coding, and theorizing of data to establish
themes.
Results
Suicide notes elucidated the writers’ conception of suicide and their emotional responses
to stressors. Expressed narratives contributing to suicide centered on burdensomeness
or guilt, experiences of mental illness, loneliness or isolation, and poor physical
health or disability. Terms related to pain, poor sleep, apology, and inability to
go on were recurrent.
Conclusions
Suicide notes enrich our understanding of the thoughts and emotions of those at highest
risk of suicide, and they inform potential interventions for reducing suicide risk
in older adults.
Key Words
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Article info
Publication history
Published online: August 31, 2022
Accepted:
August 27,
2022
Received in revised form:
August 26,
2022
Received:
March 24,
2022
Identification
Copyright
© 2022 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
