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‘He just gave up’: an exploratory study into the perspectives of paid carers on supporting older people living in care homes with depression, self-harm, and suicide ideation and behaviours

Published online by Cambridge University Press:  16 November 2018

Trish Hafford-Letchfield Open the ORCID record for Trish Hafford-Letchfield [Opens in a new window] ,
Helen Gleeson Open the ORCID record for Helen Gleeson [Opens in a new window] ,
Peter Ryan ,
Barbara Billings ,
Ruth Teacher ,
Matthew Quaife ,
Ann Flynn ,
Stefano Zanone Poma Open the ORCID record for Stefano Zanone Poma [Opens in a new window]  and
Silvia Vicentini
Trish Hafford-Letchfield*
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Helen Gleeson
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Peter Ryan
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Barbara Billings
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Ruth Teacher
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Matthew Quaife
Affiliation:
Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine, School of Health and Education, Middlesex University, London, UK
Ann Flynn
Affiliation:
Faculty of Wellbeing, Education and Language Studies, School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK
Stefano Zanone Poma
Affiliation:
Department of Mental Health, Local Health Authority of Rovigo, Rovigo, Italy
Silvia Vicentini
Affiliation:
Department of Mental Health, Local Health Authority of Rovigo, Rovigo, Italy
*
*Corresponding author. Email: p.hafford-letchfield@mdx.ac.uk
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Abstract

This study explored the concept of ‘giving up’ from the perspective of care staff working in care homes, and their everyday communication and hidden knowledge concerning what they think about this taboo topic and the context it reflects. Moving to a care home is a major transition where cumulative losses can pose risks to mental health in later life. If not recognised, this vulnerability can lead to depression which extends to suicide ideation and behaviours in the form of self-harm and self-neglect. Care homes are a significant place of care until death, yet a discourse of silence means that self-harm and suicide is under-reported or not attended to with specialist expertise. The layperson's concept of an older person ‘giving up’ on life is hardly discussed in the literature. This co-produced qualitative study used an inductive approach to explore this phenomenon through focus groups with 33 care staff across four care homes in South-East England. Findings paint a complex picture, highlighting tensions in providing the right support and creating spaces to respond to such challenging situations. ‘Giving up’ requires skilled detailed assessment to respond to risks alongside improved training and support for paid carers, to achieve a more holistic strategy which capitalises on significant relationships within a wider context.

Keywords

older peoplecare homesmental healthdepressionself-harmsuicidegiving upcare home staff
Type
Article
Information
Ageing & Society , Volume 40 , Issue 5 , May 2020 , pp. 984 - 1003
Copyright
Copyright © Cambridge University Press 2018

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