Narratives of family members on the suicide of older adults in an Amazonian metropolis

Abstract

OBJECTIVE: To analyze the narratives of family members on the suicide of older adults inManaus, State of Amazonas, Brazil.METHODS: This is a qualitative study of the narratives of eight older adults, who committedsuicide in the period of 2001–2012. In the analytic-interpretative process, we have tried to performthe hermeneutic double exercise: to interpret the interpretation of narrators. We have used astheoretical references authors who have investigated suicide from the perspective of gender andits correlations with the sociofamiliar context and with mental disorders.RESULTS: The family members would conceive the suicide of the older adults as related tolosses, which would occur in a strained sociofamiliar scenario, leading to the appearance ofpsychopathological situations that, if not properly followed, would result in death. There wouldalso be something inexorable in this sequence of events. The older adults, by the very time oftheir life, would tend to accumulate losses of different aspects in their trajectory. Their rigor andother relational limitations would simultaneously stress family relationships, favoring conflicts,and hinder adherence to treatment. This model of understanding, which has a wide support inthe hegemonic medical-psychological discourse, in a sense minimizes possible self or heteroaccusationsdirected at family members.CONCLUSIONS: Special attention should be given to identify the older adults who presentlosses, family conflicts, and signs of psychopathology and who do not follow-up psychosocialcare services. Strategies to help older adults handle family conflicts and losses, empoweringthem, should be developed and made available by intersectoral actions. The adequate treatmentof psychopathological conditions should be implanted in a context in which active searchmechanisms also existed for older adults who abandoned follow-up. The implementation ofthese actions is a challenge to be faced in Manaus, State of Amazonas, Brazil, where there is alow availability of psychosocial care services, which are not articulated with specialized careservices in tertiary medical conditions, and there is still low coverage by the basic care