Implementing and sustaining evidence-based practices in long-term care.

Suicidal Ideation and Behaviour

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    Increase your comfort, confidence and competence in this practice area, in order to enhance safety for your clients and to lower the impact of suicide to society. The goal of this best practice guideline is to provide nurses with recommendations, based on the best available evidence, related to the assessment and care of adults at risk for suicidal ideation and behaviour.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour

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    The Beers Criteria outlines medication classes that should be avoided or used with caution among older adults, including certain antidepressants, antipsychotics, benzodiazepine and medications related to dementia and cognitive impairment.

    Reference: Beers criteria for potentially inappropriate medication use in older adults (2015). American Geriatrics Society. Website: https://www.guideline.gov/summaries/summary/49933?

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    Website that deals with suicide survivors, suicide grief, support for those living with suicide loss along with providing education materials and access to various support and crisis centers . it also addresses suicide risk in the aging population. Its main purpose is to reduce suicide rate in Canada and minimize the consequences of suicide behaviour.

    Reference: Canadian Association of Suicide prevention (CASP), https://suicideprevention.ca/ 

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    Numerous resources available with a simple search engine within this website

    Reference: Centre for Suicide Prevention [Online] Available: https://www.suicideinfo.ca/resources/ 

    Copyright: The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

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    Centre for Suicide Prevention site contains a large collection of suicide prevention, intervention, and postvention resources, including Plus 65- a resource toolkit specific to seniors.

    Reference: Centre for Suicide Prevention Website: http://www.suicideinfo.ca/

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    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents’ responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

    Reference: O'Riley A, Nadorf MR, Conwell Y, Edelstein B. Challenges associated with managing suicide risk in long-term care facilities. Annals of Long-Term Care: Clinical Care and Aging. 2013;21(6):28-34. http://www.managedhealthcareconnect.com/article/challenges-associated-managing-suicide-risk-long-term-care-facilities 

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    Numerous resources available with a simple search engine. Updates noted for 2017.

    Reference: Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Deliberate Self-harm. 2016, Australian and New Zealand Journal of Psychiatry 2016, Vol 50(10) 939-1000. https://www.ranzcp.org/Files/Resources/Publications/CPG/Deliberate-self-harm-CPG.aspx  

    The Centre for Suicide Prevention Web Site is offered to you conditioned on your acceptance without modification of the terms, conditions, and notices contained herein. Your use of the Centre for Suicide Prevention Web Site constitutes your agreement to all such terms, conditions, and notices.

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    The Decision Making Framework provides an ethical approach for choosing care strategies following the observation of a deliberate act.

    Retrieved from http://ccethics.com/ethics-service/decision-making-framework/ 

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    This is a “Sentinel Event Action Alert” , a complimentary publication of The Joint Commission Issue 56, February 24, 2016 “Detecting and treating suicide ideation in all settings” Through this alert, The Joint Commission aims to assist all health care organizations providing both inpatient and outpatient care to better identify and treat individuals with suicide ideation

    Reference: Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (2016). Detecting and treating suicide ideation in all settings. [Online]. Available: https://www.jointcommission.org/assets/1/18/SEA_56_Suicide.pdf  

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    A List of educational resources compiled by the development panel as a resource for nurses and their clients in learning more about suicidal ideation and behaviour. This is not intended to be an inclusive listing.

    Registered Nurses’ Association of Ontario. (2009). Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. Toronto, ON, Canada: Author. Retrieved from http://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour