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There Was The Obvious Conclusion That A Great Deal More Could Be Done For ...

There was the obvious conclusion that a great deal more could be done for this study population in terms of relieving their social isolation and depressive illnesses. And, by extrapolation, for their risk of suicide.

Ethical considerations.
In consideration of the issue of suicide in the elderly we note that there are a number of ethical considerations but these are primarily in the field of assisted suicide which we have specifically excluded from this study. (Pabst Battin, M 1996)


Evidence for positive nursing interventions
Having established the evidence base in the literature that defines the risk factors that are known to be particularly associated with suicide in the elderly, we take it as read that this will form part of the knowledge base for the nurse to be alert to, and to identify those patients who are at particular risk of suicide. It is equally important to be aware of those factors that appear to confer a degree of protection against suicide. This will clearly also help to inform strategies of intervention for the nurse.

Studies such as that by Gunnell (D et al. 1994) point to the fact that religiosity and life satisfaction were independent protective factors against suicidal ideation, and this factor was particularly noted in another study involving the terminally ill elderly where the authors noted that higher degrees of spiritual well-being and life satisfaction scores both independently predicted lower suicidal feelings. (McClain et al. 2003).

The presence of a spouse or significant friend is a major protective factor against suicide. Although clearly it may not be an appropriate intervention for nursing care to facilitate the presence of a spouse (!) it may well be appropriate, particularly in residential settings, to facilitate social interactions and the setting up of possible friendships within that setting (Bertolote J M et al. 2003)


Conclusions and discussion

This Dissertation has considered the rationale behind the evidence base for nursing intervention and strategies to prevent or minimise suicide attempts in the elderly age group. We have outlined the literature which is directed at identification of the greatest at risk groups and this highlights the importance of the detection and treatment of both psychiatric disorders (especially major depression), and physical disorders (especially Diabetes Mellitus and gastric ulceration). (Thomas A J et al. 2004)


Although we have been at pains to point out the relatively high and disproportionate incidence of suicide in the elderly, we should not loose sight of the fact that it is not a common event. One should not take the comments and evidence presented in this dissertation as being of sufficient severity to merit screening the entire elderly population. (Erlangsen A et al. 2003) The thrust of the findings in this dissertation are that the screening should be entirely opportunistic.

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