Deliberate Self Harm and Suicidal Ideation among the Elderly in a Local Long Term Care Facility

Authors: Dr. Gerd Xuereb, Dr. Nicole Attard, Dr. Kurt Apap, Dr. Marisa Abela

Background & Aims: Deliberate self harm and suicidality among the elderly are a growing concern, yet they are often overlooked. This study investigated the prevalence of deliberate self harm and suicidality among patients residing in a long term care facility in Malta.

Method: A cross‐sectional study was conducted in St. Vincent De Paul Residence, a long term care residence with a total population of 1031 residents, 724 (70%) of whom are females. A random weighted stratified sample of 300 residents over the age of 60 was taken. The sample was stratified on gender and maintained the relative distribution of residents in the different wards at the long term care facility. The chosen participants were interviewed using the Patient Health Questionnaire-9 (PHQ-9). The participants were also asked about deliberate self harm and suicidal wishes, attempts and/or plans in the last 2 weeks. Protective factors were elicited. From the selected residents, patients suffering from cognitive impairment were excluded from the study.

Results: Sixty-seven females (68%) and thirty-one males (32%) completed the questionnaire. The ages of these ninety-eight participants ranged between 60 and 102 years, with an average age of 83.3 years. 39% of males and 58% of females who completed the questionnaire reported suicidal ideations. The most common protective factors included religion (41%) and family (29%). Four participants (4%) reported suicidal plans while 2 (2%) participants reported suicidal attempts in the last two weeks. No participants reported deliberate self harm wishes, plans and/or attempts. One hundred and ninety-nine selected residents suffered from cognitive impairment and were excluded from the study. Three residents refused to participate.

Conclusion: Suicidal ideation among the elderly residing in St. Vincent De Paul Residence is prevalent. Consequently, measures to adequately identify and manage residents with suicidal ideations should be studied.