Epidemiology of Suicide in Older Adults

This individual symposium abstract will focus on the epidemiology of suicide in older adults, with particular focus on risk factors, changing demographics, and population shifts with the baby-boomers aging. Epidemiologically, older men aged 75 and older have a suicide rate of 39.7 deaths per 100,000 in 2017, compared to the general population of 14.0 deaths per 100,000. Risk factors for suicide in older adults include functional disability, multiple chronic physical conditions, and social isolation. In addition, older adults often face stressors such as relationship issues, life crises (loss of spouse), and social factors (employment and financial challenges, housing stress, and legal issues). Limited mobility, physical and mental health conditions, and lack of social support can affect healthcare access and utilization. Many older adults do not routinely seek behavioral health treatment, with reported under-detection of mental health conditions such as depression, substance use disorders, and suicidal ideation.

Does the risk of poor mental health rise before widowhood?

Background A large body of literature has shown that transition into widowhood has detrimental effects on the surviving spouse’s health leading to elevated risks of mortality, poor mental health and hospitalisation. However, few studies have examined health outcomes before widowhood. Anticipatory grief and long term care giving are likely to lead to poor mental health conditions. Aim This paper examined whether the risk of depression and anxiety rose before the widowhood event using linked administrative data. Methods The study population was drawn from the Scottish Longitudinal Study (SLS) linked to prescribing data, available from 2009. We included all cohort members who were married in 2001 and who were aged 50 and over by 2009. We then followed the cohort for 5 years from 2009 to 2013 (N=~58,000). Andersen-Gill models were used to explore the risk of prescription of antidepressant and antianxiety drugs before and after loss of spouse adjusting for a number of confounders. The analysis was carried out separately for men and women. Results We found that the risk of depression and anxiety were higher 6 months before widowhood for women (0-3 months, HR=1.17, 95%CI 1.07-1.28; 3-6 months, HR=1.15, 95%CI 1.05-1.27) but not for men (0-3 months HR=1.07, 95% CI 0.90-1.26; 3-6 months HR=1.01, 95% CI 0.84-1.21). The risk after widowhood for men became significantly higher lasting for 2 years (0-3 months HR=1.40, 95% CI 1.21-1.61; 21-24 months HR=1.24, 95% CI 1.01-1.52). For women the elevated risk remained at a heightened level up to 2 years (0-3 months HR=1.50, 95% CI 1.29-1.75; 21-24 months HR=1.29, 95% CI 1.03-1.60). Conclusion It has been previously shown that widowhood has negative effects on a surviving partners’ health. This research shows that this effect is also apparent in women before their partner’s deaths.

Healing Strategies among Thai Buddhist Widows after Sudden of Loss of Spouse in Terrorist Attacks

Background: Both physical and psychological suffering among women after the loss of their husband as a result of traumatic events has been evident. However, little is known about the strategies used by Thai widows who are able to heal and return to normal living in areas of unrest.Objectives: The purpose of this study is to describe the healing strategies used by Thai Buddhist widows to heal their suffering from the sudden loss of their spouse in terrorist attacks.Methodology: This is a primary analysis of data generated from a qualitative study of Thai Buddhist widows who lost their spouse because of terrorist attacks in the southernmost provinces of Thailand. Five Buddhist widows were purposively selected to participate in the study, using in-depth interviews and observation for data collection. Content analysis was employed as part of the data analysis to identify and describe the strategies used by the selected participants.Results: The participants were aged between 37 and 64 years old and had experienced the loss of a spouse within the previous 2 to 10 years. They had been successful in healing their suffering. Several strategies had been used, with initial support and assistance from families and close friends. Firstly, as per the Buddhist belief system, ‘merit making’, such as praying, practicing meditation, or offering money and/or food to monks, was often performed by the women. These practices helped them to ease their anxiety about their husbands’ afterlife happiness and whether or not they were living in a good place. Secondly, venting their feelings and emotions with family and close friends, including talking to their husband’s picture, provided some suffering relief. Lastly, a deep understanding of Dukkha (suffering) and the natural law of life in Buddhism helped widows to realize the right ways to create a positive mindset and new future life.Conclusions/Recommendations: The strategies used to heal themselves from suffering by Thai Buddhist widows could be of benefit for nurses, to enable them to develop interventions that not only relieve human suffering from the unexpected loss of loved ones, but also promote mental health through healing and spiritual growth in their own lives.

Implicações da viuvez na saúde: uma abordagem fenomenológica em Merleau-Ponty

Objective: to understand the implications of widowhood on health, relating the life story of the couple, the time of union and the degree of affection to the type and severity of the pathology developed. Methodology: the study is descriptive with qualitative approach. The subjects include the least 10 elderly aged less than 60 years in case of widowhood, and without distinction of color, focusing on the appearance of disease in the period after loss of spouse. The scenario will be the Institute of Gerontological Education in the Municipality of Niterói/RJ. The technique chosen is the self-report and the instrument is the guide for semi structured interview. After data collection and transcription of the speech will be held the stage of defining the data, looking up the units of meaning to be examined in light of the theoretical referential Merleau-pontyan. Expected results: articulating the results, it expects to broaden the knowledge concerning the care of nursing in this context from the reference Merleau-pontyan. Descriptors: widowhood; nursing; psychosomatic.

The condition of mental health of industrial enterprise’s workers according to the data of the preventive examinations

789 industrial enterprise’s workers, having dangerous special conditions of work, were investigated by a questionnaire, containing 24 questions and statements about psychopathological symptoms. It was determined, that the risk factors of appearance of the psychopathological symptoms are a female sex, an age more than 40 years, a loss of spouse. The investigated factors of production (character, work experience, operating schedule, education) didn’t influenced on a frequency of appearance of the psychopathological symptoms.

In sure and uncertain faith: belief and coping with loss of spouse in later life

ABSTRACTThis paper reports a study of the religious, spiritual and philosophical responses to spouse bereavement. Twenty-five bereaved spouses aged 60 or more years living in the south of England and from Christian backgrounds were followed from the first to the second anniversary of the loss. The participants expressed a range of attitudes, from devout religious belief to well-articulated secular conceptions of the meaning of life, but the largest group had moderate spiritual beliefs that were characterised by doubts as much as hopes. Uncertain faith was more often associated with depressive symptoms and low levels of experienced meaning. Nine case studies are presented that illustrate different levels of adjustment to bereavement and both changing and stable expressions of faith across the one year of observation. Attention is drawn to the importance of both secular agencies and religious organisations developing a better understanding of older people's spiritual responses to loss. Although to many British older people, practise of the Christian faith may be less evident now than in their childhood, quality of life assessment should not ignore sources of spiritual satisfaction and dissatisfaction. Moreover, previous and especially early-life religious experiences provide useful points of reference for understanding present religious and spiritual attitudes. The study suggests that there may be a substantial need for pastoral counselling among today's older people, especially those of uncertain or conflicted belief.