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‘He just gave up’: an exploratory study into the perspectives of paid carers on supporting older people living in care homes with depression, self-harm, and suicide ideation and behaviours

Published online by Cambridge University Press:  16 November 2018

Trish Hafford-Letchfield Open the ORCID record for Trish Hafford-Letchfield [Opens in a new window] ,
Helen Gleeson Open the ORCID record for Helen Gleeson [Opens in a new window] ,
Peter Ryan ,
Barbara Billings ,
Ruth Teacher ,
Matthew Quaife ,
Ann Flynn ,
Stefano Zanone Poma Open the ORCID record for Stefano Zanone Poma [Opens in a new window]  and
Silvia Vicentini
Trish Hafford-Letchfield*
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Helen Gleeson
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Peter Ryan
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Barbara Billings
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Ruth Teacher
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Matthew Quaife
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Ann Flynn
Affiliation:
Faculty of Wellbeing, Education and Language Studies, School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
Stefano Zanone Poma
Affiliation:
Department of Mental Health, Local Health Authority of Rovigo, Rovigo, Italy
Silvia Vicentini
Affiliation:
Department of Mental Health, Local Health Authority of Rovigo, Rovigo, Italy
*
*Corresponding author. Email: [email protected]
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Abstract

This study explored the concept of ‘giving up’ from the perspective of care staff working in care homes, and their everyday communication and hidden knowledge concerning what they think about this taboo topic and the context it reflects. Moving to a care home is a major transition where cumulative losses can pose risks to mental health in later life. If not recognised, this vulnerability can lead to depression which extends to suicide ideation and behaviours in the form of self-harm and self-neglect. Care homes are a significant place of care until death, yet a discourse of silence means that self-harm and suicide is under-reported or not attended to with specialist expertise. The layperson's concept of an older person ‘giving up’ on life is hardly discussed in the literature. This co-produced qualitative study used an inductive approach to explore this phenomenon through focus groups with 33 care staff across four care homes in South-East England. Findings paint a complex picture, highlighting tensions in providing the right support and creating spaces to respond to such challenging situations. ‘Giving up’ requires skilled detailed assessment to respond to risks alongside improved training and support for paid carers, to achieve a more holistic strategy which capitalises on significant relationships within a wider context.

Keywords

older peoplecare homesmental healthdepressionself-harmsuicidegiving upcare home staff
Type
Article
Information
Ageing & Society , Volume 40 , Issue 5 , May 2020 , pp. 984 - 1003
Copyright
Copyright © Cambridge University Press 2018

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References

Azulai, A and Walsh, CA (2015) Screening for geriatric depression in residential care facilities: a systematic narrative review. Journal of Gerontological Social Work 58, 20–45.CrossRefGoogle ScholarPubMed
Bradshaw, S, Playford, D and Riazi, A (2012) Living well in care homes: a systematic review of qualitative studies. Age and Ageing 41, 429–440.CrossRefGoogle ScholarPubMed
Charmaz, K (2006) Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis. London: Sage.Google Scholar
Crocker, L, Clare, L and Evans, K (2006) Giving up or finding a solution? The experience of attempted suicide in later life. Ageing and Mental Health 10, 638–647.CrossRefGoogle ScholarPubMed
Deuter, K, Procter, N, Evans, D and Jaworski, K (2016) Suicide in older people: revisioning new approaches. International Journal of Mental Health Nursing 25, 144–150.CrossRefGoogle ScholarPubMed
Froggatt, K, Hockley, J, Parker, D and Brazil, K (2011) A system lifeworld perspective on dying in long term care settings for older people: contested states in contested places. Health and Place 17, 263–268.CrossRefGoogle ScholarPubMed
Gleeson, H, Hafford-Letchfield, T, Quaife, M, Flynn, A and Collins, D (2019) Preventing and responding to depression, self-harm, and suicidal behaviour in older people living in long term care settings: a systematic review. Aging and Mental Health 23, 1467–1477.Google Scholar
Harwood, D, Hawton, K, Hope, T and Jacoby, R (2006) Suicide in older people without psychiatric disorder. International Journal of Geriatric Psychiatry 21, 363–367.CrossRefGoogle ScholarPubMed
Kjølseth, I, Ekeberg, Ø and Steihaug, S (2010) Why suicide? Elderly people who committed suicide and their experience of life in the period before their death. International Psychogeriatrics 22, 209–218.CrossRefGoogle ScholarPubMed
Lyne, KJ, Moxon, S, Sinclair, I, Young, P, Kirk, C and Ellison, S (2006) Analysis of a care planning intervention for reducing depression in older people in residential care. Ageing and Mental Health 10, 394–403.CrossRefGoogle ScholarPubMed
Miles, MB and Huberman, AM (1994) Qualitative Data Analysis. Thousand Oaks, CA: Sage.Google Scholar
Morgan, D (1997) Focus Groups as Qualitative Research, 2nd Edn (Qualitative Research Methods Series 16). Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Murphy, BJ, Bugeja, L, Pilgrim, J and Ibrahim, JE (2015) Completed suicide among nursing home residents: a systematic review. International Journal of Geriatric Psychiatry 30, 802–814.CrossRefGoogle ScholarPubMed
Murphy, BJ, Bugeja, LC, Pilgrim, JL and Ibrahim, JE (2018) Suicide among nursing home residents in Australia: a national population-based retrospective cohort study. International Journal of Geriatric Psychiatry 33, 786–796.CrossRefGoogle Scholar
National Institute for Clinical Excellence (2011) Self-harm: Short-term Treatment and Management. Understanding NICE Guidance – Information for People Who Self-harm, Their Advocates and Carers, and the Public (Including Information for Young People Under 16 Years). London: National Institute for Clinical Excellence.Google Scholar
Nock, MK and Kessler, RC (2006) Prevalence of and risk factors for suicide attempts versus suicide gestures: analysis of the national comorbidity survey. Journal of Abnormal Psychology 115, 616–623.CrossRefGoogle ScholarPubMed
Office for National Statistics (2011) Changes in the Older Resident Care Home Population Between 2001 and 2011. London: Office for National Statistics.Google Scholar
Osgood, NJ and Brant, BA (1990) Suicidal behavior in long-term care facilities. Suicide and Life-threating Behavior 20, 113–122.Google ScholarPubMed
Osterlind, J, Hanseboh, G, Anderssons, J, Ternested, BM and Hellstrooms, I (2011) A discourse of silence: professional carers reasoning about death and dying in nursing homes. Ageing & Society 31, 529–544.CrossRefGoogle Scholar
Podgorski, CA, Langford, L, Pearson, JL and Conwell, Y (2010) Suicide prevention for older adults in residential communities: implications for policy and practice. PLOS Medicine 7, e1000254.CrossRefGoogle ScholarPubMed
Rurup, ML, Pasman, HRW, Goedhart, J, Deeg, DJH, Kerkhof, AJFM and Onwuteaka-Philipsen, BD (2011) Understanding why older people develop a wish to die: a qualitative interview study. Crisis: The Journal of Crisis Intervention & Suicide Prevention 32, 204–216.CrossRefGoogle ScholarPubMed
Shah, A and Erlangsen, A (2014) Suicide in older people: some forgotten avenues. Crisis: The Journal of Crisis Intervention & Suicide Prevention 35, 365–367.CrossRefGoogle Scholar
Spector, WD, Fleishman, JA and Pezzin, LE and Spillman, B (2001) Characteristics of Long-term Care Users. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
Suominen, K, Henriksson, M, Isometsa, E, Heila, H and Lonnqvist, J (2003) Nursing home suicides: a psychological autopsy study. International Journal of Geriatric Psychiatry 18, 1095–1101.CrossRefGoogle ScholarPubMed
Wijngaarden, E Van, Leget, C and Goossensen, A (2015) Ready to give up on life: the lived experience of elderly people who feel life is completed and no longer worth living. Social Science & Medicine 138, 257–264.CrossRefGoogle ScholarPubMed
Wilkes, J (2005) Conceptualizing place in the care of older people: the contributions of geographical gerontology. International Journal of Older People Nursing 14, 100–108.Google Scholar
World Health Organization (2004) Better Palliative Care for Older People. Geneva: World Health Organization.Google Scholar