International Psychogeriatrics

Research Article

“Why do they become vulnerable when faced with the challenges of old age?” Elderly people who committed suicide, described by those who knew them

Ildri Kjølsetha1 c1, Øivind Ekeberga2 and Sissel Steihauga3

a1 RVTS, Aker UHF, Oslo, Norway

a2 Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway

a3 SINTEF, Health Services Research, Blindern, Oslo and Helse Sør-Øst Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway

ABSTRACT

Background: Suicidal behavior among the elderly is a research field in which qualitative and quantitative methods can and should supplement each other. The objective of this qualitative study is to investigate whether the descriptions of elderly people who committed suicide, given by those who knew them, can provide common features that create recognizable patterns, and if so whether these patterns can help to shed light on the suicidal process.

Method: This is a psychological autopsy study based on qualitative interviews with 63 informants concerning 23 suicides committed by persons aged over 65 in Norway. The informants were relatives, their family doctors, and home-based care nurses. In general, the analysis of the interviews follows the systematic text condensation method.

Results: The descriptions have three main topics: life histories, personality traits and relationships. “Life histories” includes the sub-topics ability to survive and action-oriented achievers. They describe people who came through difficult circumstances when growing up and who were action-oriented in life in general and in crises. “Personality traits” includes the sub-topics obstinacy and controlling others. The informants saw the elderly people as strong-willed, obstinate and possessing a considerable ability to control themselves and those around them. “Relationships” includes the sub-topics I didn't know him and He showed no ability to meet us halfway, and describes the informants’ experience of emotionally closed persons who kept a distance in their relationships.

Conclusions: On the basis of the descriptions of the elderly people given in this study, we argue that these individuals will find difficulty in accepting and adapting to age-related loss of function since their self-esteem is so strongly associated with being productive and in control. Loss of control reveals their vulnerability – and this they cannot tolerate.

(Received November 18 2008)

(Revised January 22 2009)

(Revised March 31 2009)

(Accepted March 31 2009)

(Online publication June 12 2009)

Correspondence:

c1 Correspondence should be addressed to: Ildri Kjølseth, RVTS, Oslo University Hospital, Aker, 0514 Oslo, Norway. Phone: +47 22029007. Email: ildri.kjolseth@medisin.uio.no.