How to Prevent Suicide in Older Patients with a Neurocognitive Disorder: A Scoping Review Leading to the Development of a Clinical Guide for Healthcare Workers

如何预防老年神经认知障碍患者的自杀:一项旨在为医护人员制定临床指南的范围界定综述

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Abstract

BACKGROUND/OBJECTIVE: Healthcare professionals working with individuals living with neurocognitive disorders (NCD) express the need for training to prevent suicidal behaviors in this population. Accordingly, this paper describes the process used to develop a suicide prevention clinical guide for use in geriatric care settings. METHODS: The project involved three steps. First, a team of researchers conducted a scoping review of empirical studies on suicide among older adults with NCD, focusing on prevalence, risk and protective factors, assessment and practical interventions. Secondly, based on these findings, the team created a clinical guide that helps healthcare professionals assess needs and suicide risk and formulate action plans to improve well-being, ensure safety, and reduce the risk of suicide. RESULT: The guide was finalized after 18 months of deliberation. It enables professionals to structure their evaluation, so that no relevant aspect is overlooked, and protective factors are reinforced. It emphasizes shared responsibilities and interdisciplinary collaboration. It recommends that professionals conduct a personalized clinical assessment of unmet needs to reduce distress. During the third step, the guide was evaluated through a pilot study, involving post-training focus groups and interviews with professionals who used it in clinical practice. CONCLUSIONS: Participants' feedback was integrated into the final version of the Guide, and the results indicated that it helped dispel misconceptions about the low risk of suicide among patients with NCD, whose suicidality is frequently misinterpreted as mere disruptive behavior. Organizational barriers represent the main challenge professionals may face when using the Guide.

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