a1 RVTS, Oslo University Hospital, Aker, 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
Background: The objective of this study is to acquire an understanding of the suicides among a group of elderly people by studying how they experienced their existence towards the end of life.
Methods: This is a psychological autopsy study based on qualitative interviews with 63 informants in relation to 23 suicides committed by persons aged over 65 in Norway. Informants who knew the deceased persons well describe what the elderly person communicated to them about their experience of life in the period before the suicide and how they as informants saw and understood this. The informants comprise relatives, family doctors and home-based care nurses. The analysis of the interviews follows the systematic text condensation method.
Results: The descriptions are divided into three main elements: the elderly persons' experiences of life, their perception of themselves, and their conceptions of death. “Experience of life” has two sub-topics: this life has been lived and life as a burden. Everything that had given value to their life had been lost and life was increasingly experienced as a burden. Their “perception of themselves” concerned losing oneself. Functional decline meant that they no longer had freedom of action and self-determination. “Conceptions of death” involve the following sub-topics: acknowledgement/acceptance and death is better than life. Life had entered into its final phase, and they seemed to accept death. For some time, many of them had expressed the wish to die.
Conclusions: The results lead us to argue that their suicides should be considered as existential choices. The sum total of the different forms of strain had made life a burden they could no longer bear. Age meant that they were in a phase of life that entailed closeness to death, which they could also see as a relief.
(Received April 28 2009)
(Revised May 20 2009)
(Revised July 29 2009)
(Accepted July 30 2009)
(Online publication September 14 2009)