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Home Healthcare Nurse:
doi: 10.1097/01.NHH.0000360923.64474.ca
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Depression and Suicide Risks in Older Adults: A Case Study

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Depression and Suicide Risks in Older Adults: A Case Study

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CE TEST QUESTIONS

GENERAL PURPOSE

To present registered professional nurses with a case study illustrating the problems of depression and suicide as encountered by home health clinicians caring for older, homebound individuals.

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LEARNING OBJECTIVES

After reading this article and taking this test, you should be able to:

1. List key factors contributing to an understanding of depression and suicide in older adults.

2. Outline the diagnostic and treatment guidelines and strategies recommended for older adults who are depressed and/or suicidal.

3. Summarize the elements of the case study presented here that can help increase home health nurses' insight into depression and suicide in older adults.

1. People age 65 and over account for what percentage of all suicides?

a. about 6%

b. just under 12%

c. over 18%

d. just over 24%

2. What percentage of older adults who committed suicide visited their primary care provider on the same day?

a. 10%

b. 20%

c. 30%

d. 40%

3. A risk factor for suicide commonly seen in older adults is

a. polypharmacy.

b. dementia.

c. cohabitation.

d. delirium.

4. A tool useful for collecting valid data to present to a physician regarding a particular older patient's risk for suicide is the

a. Columbia Suicide Screen.

b. Suicide Ideation Questionnaire.

c. Diagnostic Predictive Scales.

d. Geriatric Depression Scale.

5. In the case study presented here, which of the following factors put the staff on high alert to the possibility of the patient's planned suicide on the day before a major holiday?

a. an elaborate buffet-style meal he was planning for the holiday

b. a planned relocation to another place for the day before the holiday

c. gifts purchased for staff members to celebrate the holiday

d. an expressed desire to avoid any festivities related to the holiday

6. APA guidelines cite which of the following as a factor that increases the risk of successful completion of suicide?

a. access to a highly lethal means of suicide

b. previous failed suicide attempts

c. little or no interest in food

d. unwillingness to see a counselor

7. The PHQ-2 asks how often during the past two weeks the person has

a. thought about committing suicide.

b. done anything that caused harm to self or others.

c. experienced a lack of interest or pleasure in activities.

d. felt a sense of hopelessness regarding the future.

8. The United States Preventative Task Force has identified three items as being useful in assessing suicide risk: suicidal thoughts, plans, and

a. weapons.

b. farewell notes.

c. delusions.

d. previous attempts.

9. According to Sadock and Sadock, women are more likely than men to use which of the following methods to commit suicide?

a. firearms

b. drug overdose

c. hanging

d. vehicle crash

10. According to Sadock and Sadock, men are more likely than women to use which of the following methods to commit suicide?

a. firearms

b. drug overdose

c. hanging

d. vehicle crash

11. According to the APA, once a patient is identified as being at risk for suicide, it is important that

a. the patient is admitted to a psychiatric facility.

b. the patient's family and friends are notified.

c. a suicide safety plan be developed.

d. advance directives are identified.

12. The APA specifies that which of the following factors protects against suicide?

a. short-term inpatient care

b. reminiscence about past experiences

c. an established contract for safety

d. a sense of responsibility to others

13. Treatment for older adults with increased suicide risks best involves an interdisciplinary approach aimed at reducing risk factors and

a. improving quality of life.

b. strengthening protective factors.

c. rewarding successful outcomes.

d. coming to a mutually acceptable agreement.

14. In the case study presented here, the patient made a verbal contract with the ANRP that he would not harm himself

a. before the holiday season.

b. until he completed bereavement counseling.

c. while his aging dog was still alive.

d. until he could resolve personal issues with his family.

15. In the case study presented here, which of the following provided a strong indication that the patient had relinquished his suicide plan and accepted that he was dying of natural causes?

a. his agreement to stop driving his car

b. the resolution of his depressive symptoms

c. his desire to have no further contact with his son and his nephew

d. his willingness to accept the home hospice care he previously resisted

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