The Desire to Die: Suicide and Euthanasia in the Elderly

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Mrs. Jones, 78 years old, arrived in the emergency department (ED) via ambulance. She was alert and oriented, but was having episodes of lost consciousness. She was put on the cardiac monitor and her vital signs were obtained. Her cardiac rhythm was normal. Her vital signs were as follows: Temperature 97.3°F, Pulse 43, respirations 26, blood pressure 100/58 and O2 saturation of 94% on room air. Additionally, Mrs. Jones was vomiting and had 2 loose, incontinent stools. She was pale, cool to touch and diaphoretic. Auscultation of her lungs revealed expiratory wheezes. Her brother reported finding her in her living room on the couch. He reported that she was difficult to rouse, and becoming concerned, he called 911. Prior to the ambulance arriving, Mrs. Jones vomited several times and her brother noted a significant amount of partly dissolved pills in the emesis. Upon checking her medicine cabinet, he found several prescription bottles empty and some over the counter medications open in the cabinet. He brought these medication bottles to the ED. Poison control was contacted and they recommended giving her activated charcoal to absorb the medications. The charcoal was offered and Mrs. Jones refused, stating that she wanted no treatment and had attempted to kill herself for a reason. Upon speaking to her brother, it was learned that her husband had died about one year earlier and that she had several new diagnoses in the last few months; including: Diabetes mellitus, anorexia (with marked weight loss), sleep disturbances, and mild dementia. She had been having difficulty with the management of these new illnesses and was still grieving for her husband. Because it was an attempted suicide, a crisis management team was c... ... middle of paper ... ...e depression from dementia. The Nurse Practitioner, 28(3), 18-27. Retrieved from www.tnpj.com on 2/19/04. Pelkonen, M. & Marttunen, M. (2003). Child and adolescent suicide: Epidemiology, risk factors and approaches to prevention. Pediatric Drugs, 5 (4), 243-265. Retrieved via Academic Search Primer on 3/25/04. http://web3.epnet.com Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K., & Allebeck, P. (2002). Burden of illness and suicide in elderly people: Case-control study. BMJ, 324(8), 1355-1357. Retrieved from www.bmj.com on 2/19/04. Zito, Safer, DosReis, Gardener, Soeken, Boles, & Lynch (2002). Rising prevalence of antidepressants among US youths. Pediatrics, 109 (5), 721-727. Retrieved via Academic Search Primer on 3/25/04. http://web3.epnet.com

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