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A retrospective case series of suicide attempts leading to hospice admission

Published online by Cambridge University Press:  04 July 2013

Nathan Fairman  and
Scott A. Irwin
Nathan Fairman
Affiliation:
Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Sacramento, California
Scott A. Irwin*
Affiliation:
Department of Psychiatry and Psychosocial Services, Institute for Palliative Medicine at SanDiego Hospice, San Diego, California
*
Address correspondence and reprint requests to: Scott A. Irwin, Department of Psychiatry and Psychosocial Services, Institute for Palliative Medicine at San Diego Hospice, 4311 Third Ave., San Diego, CA 92103. E-mail: sirwin@sdhospice.org
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Abstract

Objective:

This investigation sought to systematically identify and characterize a cohort of patients treated in hospice for life-limiting injuries sustained in a suicide attempt that was not immediately lethal.

Method:

We developed a case series of all completed suicides in a large, community-based hospice, from 2004 through 2010. Clinical documentation and county medical examiner reports were used to identify those deaths that resulted from a suicide attempt made prior to hospice admission. Cases were characterized in terms of basic demographic variables, the temporal sequence of events in the transition from hospital care to hospice, the mechanism of injury and medical complications, the presence of mental illness, and family involvement in decision making.

Results:

Out of a total of 20,887 hospice deaths during the study period, 8 deaths resulted from an incomplete suicide attempt made prior to hospice admission. Subjects were nearly all male (6/8), and 46 years old on average; substantially younger than the general hospice population. Drug overdose was the most common method of suicide (5/8), and irreversible anoxic brain injury was the main medical complication. The majority of subjects (6/8) had evidence of serious mental illness. Most cases were complicated by estranged family relationships; however, family members were involved in end-of-life decision making for nearly all patients.

Significance of results:

Whereas a failed suicide attempt leading to hospice appears to be a relatively rare event, patients in this population appear unique in several regards. Further study may serve to better characterize this group and prepare hospice agencies and clinicians for caring for this unique population.

Keywords

HospicePalliative CareSuicideSerious Mental Illness
Type
Case Report
Information
Palliative & Supportive Care , Volume 11 , Issue 3 , June 2013 , pp. 273 - 276
Copyright
Copyright © Cambridge University Press 2013 

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