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Places of living and places of dying: the case for preventing suicide in residential long-term care

Published online by Cambridge University Press:  06 March 2020

Briony Jain*
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Melbourne, Australia Department of Mental Health and Social Work, Middlesex University, London, UK
Viktoryia Kalesnikava
Affiliation:
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
Joseph E. Ibrahim
Affiliation:
Health Law and Ageing Research Unit, Department of Forensic Medicine, Monash University, Melbourne, Australia
Briana Mezuk
Affiliation:
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
*
*Corresponding author. Email: [email protected]

Abstract

This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

Type
Forum Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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