Suicide experiences among institutionalized older veterans in Taiwan.

PURPOSE Institutionalized veterans in Taiwan are a high-risk group for completing suicide due to their institutionalization and social minority status. The purpose of this study was to understand the suicide experiences, especially the triggers of suicide in this group. DESIGN AND METHODS Data about suicide experiences were collected from 19 older (> or =65 years) residents who had attempted suicide in four veterans' homes in Taiwan from 2006 to 2007. Transcripts from 26 tape-recorded interviews were analyzed by thematic analysis. RESULTS Five major themes related to suicide triggers were identified: illness and pain, death of close relatives or friends, conflicts with family members, disputes with friends or workers, and difficulty adapting to institutional life. IMPLICATIONS Illness and physical limitation issues were similar to suicidal findings on older people in Western culture. However, the suicidal behavior of these institutionalized, older Taiwanese veterans was influenced by expectations that did not match current social changes, money management issues, death of significant others, and changes in living environment. We suggest that money problems with paraprofessional institutional workers could be minimized among older institutionalized veterans by providing a convenient means for them to withdraw or manage money. Institutional staff should also be educated about communicating with older people and about death and dying; older residents should be educated about current social changes and money management. The study themes may be used to develop a new model for predicting suicide in this population and could be incorporated into current suicide prevention programs in clinical practice.