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Self-harm in the very old one year later: has anything changed?
Anne Pamela Frances Wand1,2, Brian Draper1,2, Henry Brodaty1,3
1Department of Aged Care Psychiatry, Prince of Wales Hospital, Sydney, NSW, Australia.
Self-harm in older adults persists due to ongoing factors, with care experiences varying significantly. Interventions should focus on communication and support for individuals and their carers.
Area of Science:
- Gerontology
- Psychiatry
- Public Health
Background:
- Self-harm in older adults is a complex issue often overlooked.
- Understanding the experiences of elderly individuals who self-harm, their carers, and general practitioners (GPs) is crucial for effective care.
Purpose of the Study:
- To conduct a 12-month follow-up of older adults (80+) who self-harmed, their carers, and GPs.
- To examine reflections on self-harm, care experiences, and outcomes from multiple perspectives.
Main Methods:
- Qualitative in-depth interviews with patients, carers, and GPs.
- Narrative inquiry and thematic analysis of interview data.
- Review of medical records and GP questionnaires.
Main Results:
- Key themes from patients included denial, suffering, invalidation, and feeling unheard.
- Carer themes highlighted patient's wish to die, clinician abandonment, and carer burden.
- GP themes indicated a perception of problem resolution and a desire for understanding.
Conclusions:
- Factors contributing to self-harm in the elderly persist.
- A conceptual framework emphasizes individual needs, interpersonal context, and carer burden.
- Interventions should enhance communication, shared understanding, and support systems.
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