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What are the suicidal risk factors for older adults - Research Paper Example

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This paper is divided into three sections, the introduction/literature review, the methodology of conducting the research, and a section outlining the limitations, policies and practice implications of preventing suicide attempts among the aged…
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What are the suicidal risk factors for older adults
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Table of Contents: Introduction and Literature Review……………………………………………3 Methodology……………………………………………………………………9 i. Overview ii. Research questions/hypotheses iii. Variable operationalization iv. Sampling v. Research Study Design vi. Data collection and Instruments vii. Data analysis plan viii. Data dissemination plan Limitations, Policy and Practice…………………………………………………..14 1. Introduction and Literature Review Suicide, among the older adults is a worrying trend. The aging population consists of 12% of the total population in United States of America (Marcovitz, 2010). There older population, are more likely to commit suicide than younger people, and this is because of their vulnerability to depression and other chronic illness. Statistic review that, prior to committing suicide, old people at the ages of 65 years and over, at one point consulted a physician, few months before the suicide act (Barry et al, 2001). This paper is a research on the suicidal risk factors facing the aged. This paper is divided into three sections, the introduction/literature review, the methodology of conducting the research, and a section outlining the limitations, policies and practice implications of preventing suicide attempts among the aged. One of the main causes of suicide among the aged is depression, and it accounts to a large percentage of the suicide deaths among older people in United States of America (Zweig, 1993). The reason as to why depression contributes to suicide among the old is the nature of treatment aged people undergo in relation to depression. Medical practitioners fail to effectively treat this disease, assuming that it is part of the aging process (Hersen, 2005). Old people suffering from depression are vulnerable to other diseases, and because their immune system is weak, they are likely to suffer from the disease in question (Roy, 2003). To mitigate this situation, it is important to reduce the risk of depression among the elderly, by improving the detection and diagnosis process of this serious medical condition. It is therefore risky for medical official to assume that depression is part of the aging process (Roy, 2003). The assumptions that grief, and emotional attitude of sadness are healthy indicators of old age, is wrong, since this can cause persistent depression, which is a health risk to the aged. These assumptions usually contribute to inefficient treatment and diagnosis of depression, resulting to a condition known as subsyndromal depression (Berman, 2010). In regard to this, to treat this condition effectively and reduce the rate of suicide among the aged, it is important to use psychotherapy and anti-depressant medications. Psychotherapy is one of the most efficient methods of treating suicide (Thompson, 2010). It involves a situation where a counselor or trained medical officer interacts with the patient for the purposes of knowing his problems and offering a solution. However, this kind of treatment is limited to old people, who are in good health (Nardoff et al, 2011). Research will help in identifying the effects of these medications among the aged, and the combined treatment of depression by use of psychotherapy and the medications. It will determine the level of prescribing this treatment, and how to effectively treat old people with mental and physical problems. Personality traits are a factor influencing suicidal tendencies among the aged. Most studies highlight that old people who commit suicide suffer from low self-esteem, depicted in their manner of interacting with others. They are shy, face hostility from the community, rigid, and are subject to a condition known as hypochondriasis (Gallagher et al, 2009). Other traits include leaving a fiercely independent life, anger and frustration. These personality elements make an elderly to have an aggressive attitude towards him, leading to psychological problems. The age person attains a feeling of hopelessness, and to him, the only solution is to take his life. However, this is not the case for all old people. Old people who experienced difficulties during their lifetime can manage to hold on to various stressful conditions affecting them. Factors such as social, economic and physical problem cannot make them commit suicide (Haussleiter, 2009). This is because they are hardened, and have skills to manipulate their conditions. Others abuse alcohol, lowering their dignity and social standing, increasing their risk of committing suicide. There is a need of research to determine the specific personality traits that makes the elderly people vulnerable to suicide (Worchel and Gearing, 2010). It will determine the relationship between these traits, and the mental condition of the aged. It will identify the necessary medications, and psychological treatment they need to undergo in order to rectify negative personality traits that makes vulnerable to suicidal acts. Physical health malfunctioning is another suicidal risk factor among the aged. Research proves that old people facing chronic illness are likely to commit suicide, that healthy old people. Diseases such as HIV AIDS, renal diseases, ulcers, and Huntington disease contribute to the likelihood of old people committing suicide (Williamson et al, 2000). Studies reveal that most of those who commit suicide due to physical ailments are men. This is because of their mental belief that old age is a state of suffering and loss, and therefore diseases are just but an agent of these sufferings. Men are vulnerable, because of their social upbringing when they were children (Kennard, 2007). They are unable to express their feelings, and these feelings build up on them, resulting to mental complications. They are unable to effectively express their attitude towards death, and therefore the notion of life impermanence takes a toll on death, resulting to suicide. The male also display an extreme version of somatic illness, as compared to their female counterparts. However, the diagnosis of a physical illness should not prevent medical practitioners from examining the mental state of the patient (Haussleiter et al, 2009). This is because medical conditions such as somatic illnesses and hypochodriacal condition will prevent the identification, and diagnosis of a mental disorder. It is essential to conduct research on the relationship between physical condition of an old person, in relation to his mental health, to determine whether the two factors are interrelated, causing suicide among the aged. This is because; elderly facing these conditions are less likely to publicly agree on the suicidal ideas (Hersen, 2005). This research will precipitate the training of medical staff to identify and diagnose these syndromes among the elderly. Socio-cultural factors also contribute to suicidal attempts among the elderly. Social isolation and loneliness is a major contributor of suicide among the old people. This people concern themselves with relationships, and specifically inter-personal relationships. They are also concerned with difficulties arising from their occupation, economic problems, and loss of family members or a close associate. Old people who are divorced, widowed or single are likely to commit suicide than those living with their spouses. Single old men are the most vulnerable in this situation to commit suicide, as opposed to single old women (Moore, 2011). On this note, marriage provides a social security, against loneliness and boredom. Another factor affecting the aged in relation to suicide attempt are the neurobiological factors. This involves the study of the serotonergic system of the human brain, and these studies reveal a decline in the brain stem cerebrospinal fluid and hydroxyindoleacetic acid. A limited value of hamovanillic acid and CSF 5 contribute to suicidal tendencies among aged people, particularly those who tried and failed in their first attempt (Morrison, 2008). Studies reveal that a combination of the genetic make-up of an individual, and the environment in which he/she stays contributes significantly to suicidal tendencies (Morrison, 2008). Researchers concentrate on the gene-environment relationship of an individual in analyzing the neurological factors causing suicide. In analyzing this aspect, researchers review the clinical studies of the gene-environment interaction, and thereafter detect the biological trails and molecular organisms that contribute to suicidal attempts among the old people (Nardoff et al, 2011). There is a need of further research in this area of neurology in relation to suicide among the old people. This will help in coming with measures and ways of treating neurological malfunctioning’s among the old people, resulting to the reduction of suicide amongst this category of people. This is further precipitated by the recent findings that epigenetic changes is present among people who commit suicide (Goodwin and Marisuc, 2011). These changes are in specific area of the brain make-up of the victim. Looking at these factors, it is proper to denote that suicide attempts among old people is a combination of various factors, and they include, social, medical and psychological problems. Friends and family members of the old person must identify signs and indicators of an objective to commit suicide from the elderly ( Leo, 2001). They should do this by making an observation of the behavior changes of the elderly, their manner of speech and attitude to those closer to them. They should observe any signs of depression, and enact measures of treating the disorder. Family members should put measures to reduce the social isolation of the aged, build on their self-esteem, improve their medical and social resources, and enhance the treatment of their psychiatrist conditions and physical ailments. In addition to these, medical practitioners and family members should evaluate any reference in connection to committing suicide, and counsel the patient (Stimming, 1999). People around the aged should not ignore statements such as, what is the use life?, I don’t want to live, I want to die. These statements may indicate the intentions of the aged person, therefore caution and care is necessary. In the long run, these measures will reduce the percentage of suicide rates among the elderly (Leo, 2001). It is essential to conduct an evaluation of the suicide risk of the individual, and this involves identifying and taking information of the individuals plan. An old person contemplating to commit suicide should seek medical care in a mental institution or a psychiatrist care. This will reduce the rate of suicide among the old people. Vulnerable old people should not access lethal weapons such as guns, domestic gas supplies, dangerous medications that can cause death, such as paracetamols and insecticides. This will limit their access to means of taking their lives, and therefore reduce the rate of suicide among the elderly. In conclusion, it is important to research on better ways and means of mitigating suicide among the elderly (Fang et al, 2012). Information from this research will help in the diagnoses of the ailments that affect old improve, and improve their social and economic welfares. 2. Methodology: i. Overview of the Study This research study aims to identify the risk factors among the aged people that contribute to suicide. This research seeks to identify how neurobiological, socio-cultural, psychological and physical conditions contribute to suicide among the aged. To get the knowledge, I plan to carry out a research by use of quantitative and qualitative methods of research. This includes using questioners, surveys, library research, and clinical research. This research will contain the methods of sampling in use, the research design, the instruments of data collection, and a plan on how to analyze and disseminate data. It highlights the implications of various policies in relation to suicide acts among the aged, and their limitations. ii. Research questions and Hypotheses: This study seeks to approve or disapprove that proper medication and treatment leads to reduction of psychological cause of suicide among the age. It also seeks to approve or disapprove that genetic make-up of an individual is the main cause of suicide among the aged population. This study seeks to prove the fact that socio-economic and cultural factors are the major contributors of suicide among the elderly. In relation to the above hypotheses, the following are the questions this paper seeks to answer. 1) What are the medical procedures that old people with mental condition face? 2) How do doctors and psychologist diagnose and treat mental and stress disorders? 3) What combination of medication is effective in treating these people? 4) How do neurological factors affect an individual in relation to committing suicide? 5) What are the specific genetic factors that affect an individual in relation to suicide attempt? 6) How can medical practitioners and sociologists mitigate these factors? 7) What are the specific socio-economic conditions that affect make old people want to commit suicide. 8) How can we solve such conditions? 9) What is the percentage of old people who have died as a result of difficult socio-economic conditions, as compared to neurological and psychological factors? iii. Variable operationalization: This stage involves identifying the variables that this research will describe, control, manipulate and measure. The independent variable under consideration are, social factors, neurological factors, and psychological factors. The dependent variables under consideration are the aged/old people. iv. Sampling: Several sampling techniques were in use such as accidental, cluster, Bernoulli and non-probability sampling. In accidental sampling, I managed to get 25 old people over the age of 65 years, and they willingly helped in my study by filling in questioneers, answering their medical situations, and instances of suicide among their peers. The questioneers did not reflect sensitive questions regarding their personality, family relations. I managed to get them within my locality. The weaknesses with this sampling method are that it is not reliable, because it is based on the locality of a researcher, and does not incorporate a wider population. To fill in the gap brought about by the inconsistencies of accidental sampling, I also used Bernoulli sampling method to acquire the population for this research. This is a more reliable sampling technique because parts of the population under investigation undergo a Bernoulli trial to determine whether it is necessary to use them as a sample. This is a trial that produces only two outcomes, either the results of success or failure. Through the internet, I was able to get the population for this sample. The number of people under consideration in these aspects was 50, and by use of Bernoulli, the number of sample reduced to 25 people, over the age of 65 years. v. Research Study Design This research will use qualitative and quantitative data collection methods. Even though quantitative data has limitations in measuring the number of the aged in relation to committing suicide, it will provide an estimate of the number in question. It is difficult to measure, in quantitative term issues such as social and cultural factors, neurobiological factors and psychological factors in relation to suicide attempts. Information from quantitative research is important for making decisions on the proper diagnostic method for the aged, and planning for their welfare. For instance, it is important for the government to know the number of old people facing treatment due to physical and psychological conditions. This data provides information that is descriptive, and therefore reliable. However, without professional help, it is difficult to interpret data emanating from this research. For example, the data will provide the number of the deaths of the old people in relation to suicide, but it won’t interpret how they died. Qualitative research is also an important element in this research. It will provide data on the design of the medical treatment and social welfare of the aged. The data will provide information such as the behavioral pattern of old people, and cite relevant cases supporting its argument. One of the weaknesses of qualitative data is that it won’t provide a numerical figure supporting its arguments. The main method in use for this research is qualitative method, because it provides specific information regarding the emotions, the needs, the behaviors, of the aged. It will identify specific areas where old people died as a result of suicide. It is also flexible to use, as a researcher will respond to the specific needs of a sample as situation demands, unlike quantitative data, which is rigid, and not flexible. The importance of using both quantitative and qualitative research is because they produce reliable results when combined. Qualitative research will identify factors that contribute to suicide among the aged, while quantitative research will determine how this factors affect the aged. vi. Data collection and Measures: The qualitative methods of collecting data in use are surveys, questioneers and interviews. There will be a series of questioneers, targeting old people. The questioneers will highlight the problems they face, why most of them contemplate committing suicide, the nature of medical treatment they undertake in case of physical and mental ailment. The questioneers will have a section where the aged will give their opinion on the socio-cultural issues that affect them. This research will use an online survey to collect data among the aged. The target group of this survey is the educated and technologically conscious old people. Its main aim is to cover a wider geographical area, while collecting data. Another method in use is the conduction of interviews. The aim of this interview is to personally learn of the predicaments of these people and come up with a conclusion and an analysis of the conditions that make them commit suicide. In collecting quantitative data, this paper focuses on polls. The researcher will design polls highlighting whether socio cultural conditions negatively affect the aged. It will require an either yes or no answer. The polls will indicate whether there is a need of enacting policies that will help in mitigating and preventing suicide. All data emanating from surveys, questioneers, interviews and polls are stored in locked files, at the school cabinet and professionally maintained. There will be procedures of protecting the identity of all the participants of the research. This is to protect them against intimidation, or stigma. In conducting interview, the interviewer will desist from making remarks that will negatively impact on the sample. This is to ensure reliability of the information he gives. vii. Data analysis plan: Data from qualitative analyze will be analyzed in relation to their reliability and contents, and further used to interpret quantitative data. The researcher will deal with any signs of inconsistencies emanating from both qualitative and quantitative data, and possibly do away with such kind of information. viii. Data Dissemination Plan: Stakeholders in this research will get the results of this research through an electronic means, specifically from the internet. The researcher will email all the information pertaining to the results of the research to various recipients, who are stake holders in the health industry. They must be people who are concerned for the welfare of the aged, and who are responsible for initiating policies for the aged. The researcher will not release the names and location of his population. 3. Limitations, Policy and Practice There are numerous limitations a researcher will encounter while researching on the risk factors that results to suicidal tendencies among the aged. An example emanates during the process of sampling. For instance accidental and Bernoulli sampling requires a lot of time. The researcher can utilize this time, in other important areas of research such as analyzing and dissemination of data. However, sampling is also a critical stage of the research. Another limitation arises on issues to do with money (Kennedy, 2001 and Leenaars et al, 1992) To effectively conduct this kind of research, it is important to have funds for the purposes of printing the questioneers, and developing surveys. However, most institutions are reluctant to fund such initiatives (Grant et al, 2003). Picking a sample from the population is a challenge. It’s difficult to find an old person who will comfortably open up, and share their personal challenges. It also becomes difficult to convince them into participating in the research (Ford, 2010). The government ought to initiate various policies for purposes of protecting the aged. It has to introduce a legislation, which identifies, and protects the various needs of the aged (Abeles, 1998). It must initiate ways and means in which this legislation is enforced, ensuring the welfare of the aged. The government must create statutory institutions that protect this people, and they can assess its services, in case they need them (Erber, 2009). The general practice in the care of the aged people is taking them to geriatric care institutions, where they are under the care of a nurse (Abeles, 1998). These institutions are responsible for the nutritional and medical health of the aging population. References: Abeles, N. (1998) What practitioners should know about working with older adults, American Psychological Association, retrieved from http://www.nova.edu/gec/forms/practitioners_older_adults.pdf Barry, K., Blow, F., & Oslin, D. (2001). Alcohol Problems in Older Adults: Prevention and Management. London: Springer Publishing Company. Berman, J., & Furst, L. M. (2010). Depressed Older Adults: Education and Screening. London: Springer Publishing Company. Erber, J. T. (2009). Aging and Older Adulthood (Wiley Desktop Editions). California: Wiley- Blackwell. Fang, F., Fall, K.,Mittleman, M., Sparen,P. ,Ye,W., Adami, H. Valdimarsdottir,U. ( 2012) Suicide and Cardiovascular Death after a Cancer Diagnosis, The New England Journal of Medicine, retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1110307 Ford, M. T. (2010). Suicide Notes. New York: HarperTeen. Gallagher-Thompson, D. and Thompson, L. W. (2009). Treating Late Life Depression: A Cognitive-Behavioural Therapy Approach, Therapist Guide (Treatments That Work). Oxford: Oxford University Press. Goodwin,R. and Marusic,A. (2011) Perception of health, suicidal ideation, and suicide attempt among adults in the community, Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21945842 Grant ,J. Brown,T. ( 2003) NAMI, retrieved from http://www.nami.org/Content/ContentGroups/MIO/CDResourceManual.pdf Haussleiter, A., Brune, M., and Juckel, G (2009) Psychopathology in Multiple Sclerosis, Therapeutic Advances in Neurological Disorders, January; 2(1): 13–29. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/ Hersen, M. (2005). Clinician's Handbook of Adult Behavioural Assessment (Practical Resources for the Mental Health Professional). New York: Academic Press. Jensen J. and Semke, J. ( undated) Chapter 7, A review of the Literature, retrieved from http://spokane.wsu.edu/researchoutreach/wimhrt/documents/Ch7.pdf Kennard, J., (2007) Men and Suicide , About.com, retrieved from http://menshealth.about.com/cs/mentalhealth/a/suicide.htm Kennedy, G. J. (2001). Geriatric Mental Health Care: A Treatment Guide for Health Professionals. New York: The Guilford Press. Leenaars, A. A. Maris, R. W. McIntosh, J. L. and Richman, J. (1992). Suicide and the Older Adult. New York: The Guilford Press. Leo, D. (2001). Suicide and Euthanasia in Older Adults: A Transcultural Journey. Massachusetts: Hogrefe & Huber Pub. Marcovitz, H. (2010). Suicide. Minneapolis: Abdo Publishing Company. Morrison-Valfre, M. (2008). Foundations of Mental Health Care. Missouri: Mosby. Moore, K, (2011) Mood Swings in Men, LIvestrong.com, retrieved from http://www.livestrong.com/article/208466-mood-swings-in-men/ Nardoff, M., Fiske, A., Sperry, J., Pettts, R., and Gregg, J., (November 2011) Insomnia Symptoms, Nightmares, and Suicidal Ideation in Older Adults, Journals of Gerontology, Series B, Psychological Sciences and Social Sciences North Dakota Suicide Prevention Program (2012) Seniors, Retrieved from http://www.ndhealth.gov/suicideprevention/?id=78 Haussleiter, A., Brune, M., and Juckel, G (2009) Psychopathology in Multiple Sclerosis, Therapeutic Advances in Neurological Disorders, January; 2(1): 13–29. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002616/ Hersen, M. (2005). Clinician's Handbook of Adult Behavioural Assessment (Practical Resources for the Mental Health Professional). New York: Academic Press. Jensen J. and Semke, J. ( undated) Chapter 7, A review of the Literature, retrieved from http://spokane.wsu.edu/researchoutreach/wimhrt/documents/Ch7.pdf Kennard, J., (2007) Men and Suicide , About.com, retrieved from http://menshealth.about.com/cs/mentalhealth/a/suicide.htm Kennedy, G. J. (2001). Geriatric Mental Health Care: A Treatment Guide for Health Professionals. New York: The Guilford Press. Leenaars, A. A. Maris, R. W. McIntosh, J. L. and Richman, J. (1992). Suicide and the Older Adult. New York: The Guilford Press. Leo, D. (2001). Suicide and Euthanasia in Older Adults: A Transcultural Journey. Massachusetts: Hogrefe & Huber Pub. Marcovitz, H. (2010). Suicide. Minneapolis: Abdo Publishing Company. Morrison-Valfre, M. (2008). Foundations of Mental Health Care. Missouri: Mosby. Moore, K, (2011) Mood Swings in Men, LIvestrong.com, retrieved from http://www.livestrong.com/article/208466-mood-swings-in-men/ Nardoff, M., Fiske, A., Sperry, J., Pettts, R., and Gregg, J., (November 2011) Insomnia Symptoms, Nightmares, and Suicidal Ideation in Older Adults, Journals of Gerontology, Series B, Psychological Sciences and Social Sciences North Dakota Suicide Prevention Program (2012) Seniors, Retrieved from http://www.ndhealth.gov/suicideprevention/?id=78 Roy, R, ( 2003) Depression and Suicide in Older Adults, Retrieved from http://www.personalityresearch.org/papers/roy.html Stimming, M. and Stimming, M. (1999). Before Their Time: Adult Children's Experiences of Parental Suicide. Philadelphia: Temple University Press. Substance Abuse and Mental Health Services Administration (SAMHSA). (2010). Promoting Emotional Health and Preventing Suicide: A Toolkit for Senior Living Communities. New York: Center for Mental Health Services. Therapy News , (2011) Older Adults Prefer Psychotherapy to Pharmacology for Anxiety Treatment, GoodTherapy.Org, retrieved from http://www.goodtherapy.org/blog/psychotherapy-anxiety-treatment-preferred-over- pharmacology/ Thompson, D. G. Steffan, A. and Thompson, L. W. (2010). Handbook of Behavioural and Cognitive Therapies with Older Adults. London: Springer. U.S. Dept of Health and Human Services. (2000). Depression and suicide facts for older adults. New York: National Institute of Mental Health. Williamson, G. M. Shaffer, D. R. and Parmelee, P. A. (2000). Physical Illness and Depression in Older Adults - A Handbook of Theory, Research, and Practice (The Plenum Series in Social/Clinical Psychology) (The Springer Series in Social Clinical Psychology). London: Springer. Worchel, D. and Gearing, R. E. (2010). Suicide Assessment and Treatment: Empirical and Evidence-Based Practices. London: Springer Publishing Company. Zweig, R., & Hinrichsen, G. (1993). Factors associated with suicide attempts by depressed older adults: A prospective study. American Journal of Psychiatry. 150, 1687-1692. Read More
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