Rosowsky E
Department of Psychiatry, Harvard Medical School, Boston, MA.
Am J Psychother. 1993 Winter;47(1):127-42. doi: 10.1176/appi.psychotherapy.1993.47.1.127.
The suicidal elderly patient in the nursing home has been the focus of inadequate attention. Given the longer life expectancy, we can project that the nursing home as a context of end-life care will be utilized by increasing numbers of elderly. This article presents a case of a suicide in a nursing home and a review of the relevant current literature. A mental health consultation to the administration and staff of the nursing home following the suicide is presented as an effective way to promote healing and limit adverse sequelae. In addition, a view of the concept of institutional care to the elderly is discussed. Relocation to a nursing home as a catalyst for suicidal behavior and the notion of "goodness of fit" as it applies to resident adaptation to the nursing home is posited. A continuum of suicidality is proposed. Suicidal ideation and Intentional Life Threatening Behaviors (ILTBs) are described as adapting to the context of the nursing home, and examples are offered. The article concludes with a model of suicide probability in the nursing home resident.
养老院中具有自杀倾向的老年患者一直未得到充分关注。鉴于预期寿命的延长，我们可以预计，作为临终关怀场所的养老院将会被越来越多的老年人所使用。本文介绍了一例养老院自杀案例，并对相关的当前文献进行了综述。文中提出，在自杀事件发生后，对养老院管理人员和工作人员进行心理健康咨询是促进康复和减少不良后果的有效方法。此外，还讨论了对老年人机构护理概念的看法。文中假定，搬到养老院是自杀行为的一个诱因，以及适用于居民适应养老院情况的“契合度”概念。文中提出了一个自杀倾向的连续体。自杀意念和故意危及生命行为（ILTBs）被描述为适应养老院环境的情况，并给出了示例。文章最后给出了一个养老院居民自杀可能性的模型。
