Care home transition and risk of suicidal behaviour: a nationwide Danish registry-based study

Suicidal risk factors like social isolation, functional impairment and chronic diseases are common in care home residents, yet suicidal behaviour during care home transition is poorly described. We aimed to assess rates of suicide and suicide attempt during care home transition and to describe the methods involved.

Using nationwide health registries, we identified all individuals who moved into care homes in Denmark between January 2015 and December 2023, and investigated incidence rates (IRs) of suicide and suicide attempts relative to move-in, and the suicidal methods used.

Of 129 193 individuals, 148 residents either attempted or died by suicide from 2015 to 2023. In the 3-year period leading up to move-in, the IRs of suicide attempts increased from 96 attempts per 100 000 person-years (95% CI: 68-136) 3 years before to 610 attempts per 100 000 person-years (95% CI: 530-701) in the quarter before move-in. After move-in, however, the IR dropped instantly and reached levels as low as 41-77 per 100 000 person-years from the fifth quarter onwards. The IRs of suicide was 27 per 100 000 person-years after move-in and varied insignificantly afterwards. Suicide by hanging was most common (36%), while self-poisoning (41%) was the dominant method for attempted suicide.

Suicide attempt rates peaked in the quarters before care home transition, while rapidly decreasing after move-in. The incidence rates of suicides appeared stable after move-in. To prevent suicidal behaviour relative to care home transition, it seems imperative to improve our understanding of how to meet older citizens' need in case of physical, cognitive and mental impairment.