AccScience Publishing / IJPS / Online First / DOI: 10.36922/ijps.0777
Cite this article
53
Download
1866
Views
Journal Browser
Volume | Year
Issue
Search
News and Announcements
View All
RESEARCH ARTICLE

“It’s like an oak tree growing slowly across a barbed wire fence:” Learning from traumatic experience of bereavement by suicide in later life

Trish Hafford-Letchfield1* Jeffrey R. Hanna2,3 Evan Grant1 Lesle Ryder-Davies1 Nicola Cogan1 Jolie Goodman1 Susan Rassmussen1
Show Less
1 Department of Social Work and Social Policy, Faculty of Humanities and Arts, University of Strathclyde, Glasgow, Scotland, UK
2 Faculty of Humanities, Arts and Social Sciences, Ulster University, Belfast, N. Ireland, UK
3 South Eastern Health and Social Care Trust, Ulster Hospital, Dundonald, N. Ireland, UK
IJPS 2024, 10(2), 44–60; https://doi.org/10.36922/ijps.0777
Submitted: 22 April 2023 | Accepted: 30 October 2023 | Published: 20 December 2023
(This article belongs to the Special Issue Active Ageing and Educational Gerontology)
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Bereavement by suicide is a traumatic and life-changing experience. However, little is known about the lived experiences of people bereaved by suicide themselves, and older people’s voices are notably absent from the current suicide prevention and intervention strategies. This paper seeks to understand the different individual experiences and pathways arising from the suicide research for people in later life who have been bereaved by suicide through the lens of transformational learning. Using a qualitative paradigm, we explored the critical themes and features evident in the meaning making, coping, and adaptation needs of 24 people aged 66 – 92 years who were bereaved by suicide. In-depth interviews led by researchers with lived experience generated two themes on the centrality of experience: Critical reflection and meaning making in later life following suicide trauma; and the journey of discovery and how this interacted with social and political rights. Findings suggest that further research is necessary to generate practice-based evidence, which identifies the impact of bereavement by suicide on people in later life and how their needs for support might be unique when being assessed and identified; and how to respond more holistically to older people with psychosocial problems, which stem from these learning experiences. Recommendations consider the potential for developing more service user-led social, community-based, and therapeutic interventions, which utilizes the authentic knowledge of older people with lived experiences.

Keywords
Bereavement
Suicide
Later life
Transformational learning
Peer support
Funding
University of Strathclyde
Conflict of interest
The authors declare no conflicts of interest.
References

Andriessen, K., Krysinska, K., Kõlves, K., & Reavley, N. (2019). Suicide postvention service models and guidelines 2014- 2019: A systematic review. Frontiers in Psychology, 10:2677. https://doi.org/10.3389/fpsyg.2019.02677

 

Arbuthnott, A.E., & Lewis, S.P. (2015). Parents of youth who self-injure: A review of the literature and implications for mental health professionals. Child and Adolescent Psychiatry and Mental Health, 9:35. https://doi.org/10.1186/s13034-015-0066

 

Barlow, C.A., & Coleman, H. (2003). The healing alliance: How families use social support after suicide. Omega, 47:187-201. https://doi.org/10.2190/8N00-477Q-KUN1-5ACN

 

Berring, L.L., Buus, N., & Hybholt, L. (2021). Exploring the dynamics of a research partnership in a co-operative inquiry: A qualitative study. Issues in Mental Health Nursing, 42(9):818-826. https://doi.org/10.1080/01612840.2021.1875275

 

Burke, P.J., & Jackson, S. (2007). Reconceptualising Lifelong Learning: Feminist Interventions. Abingdon: Routledge.

 

Burnes, D., Sheppard, C., Henderson, C.R., Wassel, M., Cope, R., Barber, C., et al. (2019). Interventions to reduce ageism against older adults: A systematic review and meta-analysis. American Journal of Public Health, 109(8):e1–e9. https://doi.org/10.2105/ajph.2019.305123

 

Charmaz, K. (2006). Constructing Grounded Theory. A Practical Guide to Qualitative Analysis. London, UK: Sage.

 

Chatterji, S., Byles, J., Cutler, D., Seeman, T., & Verdes, E. (2015). Health, functioning and disability in older adults-current status and future implications. The Lancet, 385:563-575. https://doi.org/10.1016/S0140-6736(14)61462-8

 

Clarke, C.S., & Wrigley, M. (2004). Suicide-related bereavement and psychiatric morbidity in the elderly. Irish Journal of Psychological Medicine, 21:22-24. https://doi.org/10.1017/S0790966700008119

 

Collom, J.R.D., Davidson, J., Sweet, D., Gillard, S., Pinfold, V., & Henderson, C. (2019). Development of a peer-led, network mapping intervention to improve the health of individuals with severe mental illnesses: Protocol for a pilot study. BMJ Open, 9:e023768. https://doi.org/10.1136/bmjopen-2018-023768

 

Cranton, P. (2006). Understanding and Promoting Transformative Learning. 2nd ed. San Francisco: Jossey-Bass.

 

De Groot, M., de Keijser, J., Neeleman, J., Kerkhof, A., Nolen, W., & Burger, H. (2007). Cognitive behaviour therapy to prevent complicated grief among relatives and spouses bereaved by suicide: Cluster randomised controlled trial. BMJ, 334(7601):994. https://doi.org/10.1136/bmj.39161.457431.55

 

Devota, K., Woodhall-Melnik, J., Pedersen, C., Wendaferew, A., Dowbor, T.P., Guilcher, S.J.T., et al. (2016). Enriching qualitative research R by engaging peer interviewers: A case study. Qualitative Research, 16:661-680. https://doi.org/10.1177/1468794115626244

 

DHSC (Department of Health and Social Care). (2012). Policy Paper: Suicide Prevention Strategy for England. Available from https://www.gov.uk/government/publications/ suicide-prevention-strategy-for-england [Last accessed on 2023 Aug 23].

 

DHSC (Department of Health and Social Care). (2019). Policy Paper: Suicide Prevention: Cross-government Plan. Available from: https://www.gov.uk/government/ publications/suicide-prevention-cross-government-plan [Last accessed on 2023 Aug 23].

 

Dirkx, J.M. (2000). After the burning bush: Transformative learning as imaginative engagement with everyday experience. In: Wiessner, C.A., Meyer, S.R., & Fuller, D.A., (eds.), Challenges of Practice: Transformative Learning in Action: The Proceedings of the 3rd International Conference on Transformative Learning. New York, The Center for Educational Outreach and Innovation, Teachers College, Columbia University, p.247-252.

 

Dirkx, J.M. (2006). Engaging emotions in adult learning: A Jungian perspective on emotion and transformative learning. New Directions in Adult and Continuing Education, 109:15-26. https://doi.org/10.1002/ace.204

 

Faulkner, A., Carr, S., Gould, D., Khisa, C., Hafford-Letchfield, T., Cohen, R., et al. (2021). ‘Dignity and respect’: An example of service user leadership and co-production in mental health research. Health Expectations, 24:10-19. https://doi.org/10.1111/hex.12963

 

Fegg, M., Kraus, S., Graw, M., & Bausewein, C. (2016). Physical compared to mental diseases as reasons for committing suicide: A retrospective study. BMC Palliative Care, 15:14. https://doi.org/10.1186/s12904-016-0088-5

 

Fielden, J.M. (2003). Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide. International Journal of Mental Health Nursing, 12:74-85. https://doi.org/10.1046/j.1440-0979.2003.00271.x

 

Gleeson, H., Roesch, C., Hafford-Letchfield, T., & Ellmers, T. (2022). Assessing suicide ideation among older adults: A systematic review of screening and measurement tools. International Psychogeriatrics, 34(5):439-452. https://doi.org/10.1017/S1041610221002659

 

Groos, A.D., & Shakespeare-Finch, J. (2013). Positive experiences for participants in suicide bereavement groups: A grounded theory model. Death Studies, 37(1):1-24. https://doi.org/10.1080/07481187.2012.687898

 

Hafford-Letchfield, T. (2010). The age of opportunity? revisiting assumptions about the life-long learning opportunities of older people using social care services. The British Journal of Social Work, 40:496-512. https://doi.org/10.1093/bjsw/bcp004

 

Hafford-Letchfield, T. (2016). Learning in Later Life: Challenges for Social Work and Social Care. London: Routledge, p.200.

 

Hafford-Letchfield, T., & Formosa, M. (2016). Mind the gap! An exploration of the role of lifelong learning in promoting co-production and citizenship within social care for older people. European Journal for Research on the Education and Learning of Adult,7(2):237-252. https://doi.org/10.3384/rela.2000-7426.rela0154

 

Hafford-Letchfield, T., Gleeson, H., Ryan, P., Billings, B., Teacher, R., Quaife, M., et al. (2020). ‘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. Ageing and Society, 40:984-1003. https://doi.org/10.1017/S0144686X18001447

 

Hafford-Letchfield, T., Hanna, J., Grant, E., Ryder-Davies, L., Cogan, N., Goodman, J., et al. (2021). Bereavement by Suicide in Later Life: Project Report. Glasgow, UK: University of Strathclyde. Available from: https://pureportal.strath. ac.uk/en/publications/bereavement-by-suicide-in-later-life-project-report [Last accessed on 2023 Oct 26].

 

Hafford-Letchfield, T., Hanna, J., Grant, E., Ryder-Davies, L., Cogan, N., Goodman, J., et al. (2022b). “It’s a living experience”: Bereavement by suicide in later life. International Journal of Environmental Research and Public Health, 13:e7217. https://doi.org/10.3390/ijerph19127217

 

Hafford-Letchfield, T., Jain, B., Gleeson, H., Roesch, C., & Ellmers, T. (2022a). A scoping review exploring the ‘grey area’ of suicide-related expression in later life: Developing a conceptual framework for professional engagement. Ageing and Society, Online First:1-30. https://doi.org/10.1017/S0144686X22000642

 

Hansson, R.O., & Stroebe, M.S. (2007). Bereavement in Late Life: Coping, Adaptation, and Developmental Influences. Washington, DC: American Psychological Association. https://doi.org/10.1037/11502-000

 

Hashim, S.M., Eng, T.C., Tohit, N., & Wahab, S. (2013). Bereavement in the elderly: The role of primary care. Mental Health Family Medicine, 10:159-162.

 

Heisel, M.J., Moore, S.L., Flett, G.L., Norman, R.M.G., Links, P.S., Eynan, R., et al. (2020). Meaning-centered men’s groups: Initial findings of an intervention to enhance resiliency and reduce suicide risk in men facing retirement. Clinical Gerontologist, 43:76-94. https://doi.org/10.1080/07317115.2019.1666443

 

Higgins, A., Hybholt, L., Meuser, O.A., Eustace Cook, J., Downes, C., & Morrissey, J. (2022). Scoping review of peer-led support for people bereaved by suicide. International Journal of Environmental Research and Public Health, 19(6):3485. https://doi.org/10.3390/ijerph19063485

 

Hybholt, L., Buus, N., Erlangsen, A., & Lauge Berring, L. (2020a). Older adults bereaved by suicide: A systematic literature search identifying zero studies. Archives of Suicide Research, 24:119-124. https://doi.org/10.1080/13811118.2018.1509751

 

Hybholt, L., Higgins, A., Buus, N., Berring, L.L., Connolly, T., Erlangsen, A., et al. (2022). The spaces of peer-led support groups for suicide bereaved in Denmark and the republic of Ireland: A focus group study. International Journal of Environmental Research, and Public Health, 19:9898. https://doi.org/10.3390/ijerph19169898

 

Hybholt, L., Lauge Berring, L., Erlangsen, A., Fleischer, E., Toftegaard, J., Kristensen, E., et al. (2020b). Older adults’ conduct of everyday life after bereavement by suicide: A qualitative study. Frontiers in Psychology, 11:e1131. https://doi.org/10.3389/fpsyg.2020.01131

 

Illeris, K. (2007). How We Learn: Learning and non-Learning in Schools and Beyond. London and New York: Routledge.

 

Illeris, K., (ed.) (2009). A Comprehensive understanding of human learning. In: Contemporary Theories of Learning. Oxon: Routledge, p.7-20.

 

Jarvis, P. (2001). Learning in Later Life: An Introduction for Educators and Carers. London: Kegan Paul.

 

Jarvis, P. (2009). Learning to be a Person in Society. London: Routledge.

 

Jordan, J.R. (2001). Is suicide bereavement different? A reassessment of the literature. Suicide and Life-Threatening Behavior, 31(1):91-102. https://doi.org/10.1521/suli.31.1.91.21310

 

Kashaniyan, F., & Khodabakshi Koolaee, A. (2015). Effectiveness of positive psychology group interventions on meaning of life and life satisfaction among older adults. Elderly Health Journal, 1(2):68-74.

 

Kegan, R., & Lahey, L.L. (2009). Immunity to Change: How to Overcome It and Unlock the Potential in Yourself and Your Organization. Boston: Harvard Business Press.

 

Koo, Y.W., Kõlves, K., & De Leo, D. (2017). Suicide in older adults: Differences between the young-old, middle-old, and oldest old. International Psychogeriatrics, 29:1297-1306. https://doi.org/10.1017/S1041610217000618

 

Linde, K., Treml, J., Steinig, J., Nagl, M., & Kersting, A. (2017). Grief interventions for people bereaved by suicide: A systematic review. PLoS One, 12(6):e0179496. https://doi.org/10.1371/journal.pone.0179496

 

MacIntyre, G., Cogan, N., Stewart, A., Quinn, N., Rowe, M., O’Connell, M., et al. (2019). Understanding citizenship within a health and social care context in Scotland using community-based participatory research methods. In: Sage Research Methods Cases Part 1. United States: SAGE Publications Ltd. https://doi.org/10.4135/9781526484918

 

Matua, G.A., & Van Der Wal, D.M. (2015). Differentiating between descriptive and interpretive phenomenological research approaches. Nurse Research, 22:22-27. https://doi.org/10.7748/nr.22.6.22.e1344

 

McDaid, D., Knapp, M., Medeiros, H., & Simon, H. (2008). Employment and Mental Health: Assessing the Economic Impact and the Case for Intervention. London: PSSRU/LSE.

 

Mckenzie, S.K., Li, C., Jenkin, G., & Collings, S. (2017). Ethical considerations in sensitive suicide research reliant on non-clinical researchers. Research Ethics, 13:173-183. https://doi.org/10.1177/17470161166499996

 

Mezirow, J. (2000). Learning as Transformation: Critical Perspectives on a Theory in Progress. San Francisco, The Jossey-Bass Higher and Adult Education Series, p.271.

 

Mezirow, J. (2003). Transformative learning as discourse. Journal of Transformative Education, 1:58-63. https://doi.org/10.1177/1541344603252172

 

Mezirow, J., & Taylor, E.W. (2009). Learning Transformation in Practice: Insights from Community, Workplace and Higher Education. San Francisco, Josey-Bass.

 

Miles, M.B., & Huberman, A.M. (1994). Qualitative Data Analysis. Thousand Oaks, CA, USA: Sage.

 

Moon, P.J. (2009). Making explicit the contention in hospice care. American Journal of Hospice and Palliative Medicine, 26(6):432-438. https://doi.org/10.1177/1049909109338389

 

Naef, R., Ward, R., Mahrer-Imhof, R., & Grande, G. (2013). Characteristics of the bereavement experience of older persons after spousal loss: An integrative review. International Journal of Nursing Studies, 50(80):1108-1121.

 

Neimeyer, R.A., & Sands, D.C. (2017). Suicide loss and the quest for meaning. In: Andriessen, K., Krysinska, K., & Grad, O.T., (eds.), Postvention in Action: The International Handbook of Suicide Bereavement Support. Germany: Hogrefe, p.71-84.

 

Nind, M. (2017). The practical wisdom of inclusive research. Qualitative Research, 17:278-288. https://doi.org/10.1177/14687941177081

 

NSUN. (2015). Service User Involvement in Health and Social Care Policy and Legislation. Available from: https://nsun. org.uk [Last accessed on 2023 Oct 26].

 

Ozuem, W., Willis, M., & Howell, K. (2022). Thematic analysis without paradox: Sensemaking and context. Qualitative Market Research: An International Journal, 25(1):143-157. https://doi.org/10.1108/QMR-07-2021-0092

 

Percy, K. (1990). The future of educational gerontology: A second statement of first principles. In: Glendenning, F., Percy, K., (eds.), Ageing, Education and Society: Readings in Educational Gerontology. Keele: Association for Educational Gerontology, p.232-239.

 

Pitman, A., Osborn, D., King, M., & Erlangsen, A. (2014). Effects of suicide bereavement on mental health and suicide risk. Lancet Psychiatry, 1(1):86-94. https://doi.org/10.1016/S2215-0366(14)70224-X

 

Pitman, A.L., Osborn, D.P.J., Rantell, K., & King, M.B. (2017). Bereavement by suicide as a risk factor for suicide attempt: A cross sectional national UK wide study of 3432 young, bereaved adults. BMJ Open, 6:e009948. https://doi.org/10.1136/bmjopen-2015009948

 

Samaritans. (2020). Guidance for Working with People Bereaved by Suicide. Available from: https://www.samaritans.org/ scotland/about-samaritans/media-guidelines/guidance-working-people-bereaved-suicide [Last accessed on 2023 Oct 27].

 

Sand, D., & Tenant, M. (2010). Transformative learning in the context of suicide bereavement. Adult Education Quarterly, 60:99-121. https://doi.org/10.1177/0741713609349932

 

Sandelowski, M. (1991). Telling stories: Narrative approaches in qualitative research. The Journal of Nursing Scholarship, 23:161-166. https://doi.org/10.1111/j.1547-5069.1991.tb00662.x

 

Shah, A., & Erlangsen, A. (2014). Suicide in older people: Some forgotten avenues. Crisis, 35:365-367. https://doi.org/10.1027/0227-5910/a000297

 

Shah, S.N., & Meeks, S. (2012). Late-life bereavement and complicated grief: a proposed comprehensive framework. Aging and Mental Health, 16:39-56. https://doi.org/10.1080/13607863.2011.605054

 

Soulsby, J. (2014). Editorial essay: Learning in later life - projects, conferences, and examples of practice in Europe. International Journal of Education and Ageing, 1(1):77-86.

 

Stiles, W.B., & Brinegar, M.G. (2007). Insight as a stage of assimilation: A theoretical perspective. In: Castonquay, L.G., & Hill, C., (eds.), Insight in Psychotherapy. USA: American Psychological Association, p.101-118. https://doi.org/10.1037/11532-005

 

Sun, J., Yin, X., Li, C., Liu, W., & Sun, H. (2022). Stigma and peer-led interventions: A systematic review and meta-analysis. Frontiers in Psychiatry, 13:915617. https://doi.org/10.3389/fpsyt.2022.915617

 

Sundler, A.J., Lindberg, E., Nilsson, C., & Palmér, L. (2019). Qualitative thematic analysis based on descriptive phenomenology. Nursing Open, 6(3):733-739. https://doi.org/10.1002/nop2.275

 

UK Parliament. (2022). Suicide Statistics. London: House of Commons Library. Available from: https://commonslibrary.parliament.uk/research-briefings/cbp-7749 [Last accessed on 2023 Dec 15].

 

UK Parliament. (2023). Suicide Prevention: Policy and Strategy. Available from: https://commonslibrary.parliament.uk/ research-briefings/cbp-8221 [Last accessed on 2023 Apr 22].

 

United Nations. (2015). Sustainable Development. Available from: https://sdgs.un.org/goals [Last accessed on 2023 Oct 26].

 

Wand, A.P.F., Zhong, B.L., Chiu, H.F.K., Draper, B., & De Leo, D. (2020). COVID-19: The implications for suicide in older adults. International Psychogeriatrics, 32(10):1225-1230. https://doi.org/10.1017/S1041610220000770

 

Withnall, A. (2010). Improving Learning in Later Life. London: Routledge, p.138.

 

World Health Organisation. (2014). Preventing Suicide: A Global Imperative. Available from: https://www.who. int/publications/i/item/9789241564779 [Last accessed on 2023 Aug 23].

 

World Health Organisation. (2017). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide [Last accessed on 2023 Oct 26].

 

World Health Organisation. (2019). Suicide in the World: Global Health Estimates. Geneva: World Health Organisation.

 

World Health Organisation. (2021). Suicide. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide [Last accessed on 2023 Aug 21].

Share
Back to top
International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing