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2003), Have The Warning Signs Of Impending Suicide Recognised And Acted Upon ...

2003), have the warning signs of impending suicide recognised and acted upon more promptly than the younger, arguably more independent age group.

In specific consideration of the elderly group we should also note that attempted suicide is more likely to be a failed suicide attempt rather than a parasuicide. (Rubenowitz E et al. 2001).


There is considerable evidence that the incidence of depression is increased in the presence of a concurrent physical illness (Conwell Y et al. 2002) and clearly this is going to be more likely in the elderly age group. Some sources have cited association rates of between 60-70% of major depression with physical illness in the over 70yr olds. (Conwell Y et al. 2000).


Another significant factor is that it is commonly accepted that an attempted suicide is a strong independent risk factor in the aetiology of further suicide attempts. (Conwell Y et al. 1996) This trend is much more marked in the elderly group with a ratio of about 4:1 which compares very badly with the ratios in the younger age groups of between 8:1 and 200:1 (depending on age range, definition and study). (Hepple J et al. 1997)


Aims and objectives
In this dissertation it is intended to gain evidence based knowledge of the scope and significance of the phenomenon of attempted suicide in the elderly. In addition it is intended to gain evidence based knowledge in the use of strategies to ameliorate attempted suicide in the elderly to highlight gaps in the literature available and to suggest recommendations for change in nursing practice It is hoped to be able to suggest areas for research into the phenomenon of attempted suicide in the elderly.

Methodology
The initial strategy was to undertake a library search at the local post graduate library and the local university library (Client: you might like to personalise this) on the key words suicide, elderly, prevention strategies, industrialised societies. This presented a great many papers. About 40 were selected and read to provide an overview of the literature in this area. During this phase, references were noted and followed up and key literary works were assimilated. The bulk of the papers accessed and read were published within the last decade, however a number of significant older references were also accessed if they had a specific bearing on a particular issue. The most significant references were accessed and digested. The dissertation was written referencing a selected sub-set of these works.

Rationale for proposal

To increase nurses knowledge and understanding of attempted suicide in the older age group and to highlight through the literature review, evidence based strategies that an be employed to ameliorate attempted suicide amongst the elderly.

Literature review
Before commencing the literature review, it is acknowledged that the literature on this subject is huge. The parameters of the initial search have been defined above.


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