Does perceived burdensomeness erode meaning in life among older adults?

Abstract

Background Identification of risk factors for loss of meaning in life among older adults is needed. In the current paper, we test hypotheses derived from the Interpersonal Theory of Suicide concerning the role of perceptions that one is a burden on others as a risk factor for lower meaning in life. Methods A prospective design was used to examine the temporal associations between perceptions of burdensomeness on others and perceived meaning in life among older adults (n = 65) seeking mental health treatment (primarily for depression and/or anxiety) at an outpatient geriatric mental health clinic. Participants completed self-report questionnaires within a month following intake. Follow-up questionnaires were completed over the phone two months later. Results Perceived burdensomeness predicted lack of meaning in life two months later, while accounting for depression severity. In contrast, baseline levels of meaning in life did not significantly predict levels of burdensomeness at two months. Conclusion The findings suggest that burdensomeness may contribute to suicide morbidity and mortality in late-life by eroding meaning in life. Empirically supported treatments for late-life depression could be adapted to focus on perceptions of burdensomeness and its connections with meaning in life.

Attitudes towards end-of-life decisions in case of long-term care dependency: a survey among the older population in Austria

“…Irrespectively, given the acceptance of PAS/EUT for cases of severe long-term care dependency in old age among more than one-third of the older population in Austria, it seems that discussions about PAS/EUT should not be restricted to terminally ill patients or to those suffering from physical pain per se. More generally, our results call for more attention within the debate on ELDs towards the situation of older adults who are tired of living22 due to a perceived loss of autonomy and dignity, due to loneliness or perceived burdensomeness in the context of prolonged care dependency, all of which can erode the meaning of life 23 24. In this respect, it is important to note that our study referred to attitudes among the general older population—rather than to preferences or the inclination to use PAS/EUT among actual care-dependent older adults—and, therefore, likely partially reflects negative stereotypes and fears about living as a care-dependent older adult.…”

Do Meaning in Life and Purpose in Life Protect Against Suicide Ideation Among Community-Residing Older Adults?

“…Van Orden et al (2012) recently demonstrated that depression severity and self-perceived burden upon others had a significant negative impact on MIL over a 2-month period of follow-up among mental healthcare-seeking older adults with mood and anxiety disorders. Their findings support the literature demonstrating negative associations between aspects of psychopathology and MIL, and support the validity of the GSIS MIL subscale.…”

Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

“…Study participants specifically endorsed reduction in the presence or severity of thoughts of suicide and the wish to die, factors conceptually [58] and empirically associated with risk for death by suicide [59]. Participants additionally endorsed a significant reduction in a sense of having lost one's personal and social worth, reflecting enhanced mental health and well-being in the context of age-related life transitions and decreased burden, a variable significantly associated with suicide risk in later life [23,42]. Significant improvement in perceptions of meaning in life, an existential variable negatively associated with depression, hopelessness, suicide ideation, and the wish to hasten death [21,60,61], and positively associated with psychological well-being and longevity [22,62-64], further attests to the potential benefit of adapted IPT for at-risk older adults.…”

“…Using core IPT techniques of interpersonal incident analysis and communication analysis, participants were helped to clarify factors contributing to their psychological pain and to improve the expression of their interpersonal needs and help alleviate despair. Feelings of emptiness, worthlessness, hopelessness, and meaninglessness are common among suicidal older adults [21,23,40]. Opportunities were thus identified for enhancing social connections, engaging in meaningful activities, and reducing exposure to painful, invalidating, or self-defeating interpersonal interactions.…”

“…The positive effect of MIL was most robust at higher levels of depressive symptom severity [22]. IPT problem areas regarding death, losses, and transitions are consistent with existential concerns that may engender perceptions of meaninglessness [21-23]. We thus adapted IPT from existing treatment manuals [24,25] incorporating lessons learned from reports of suicide during psychotherapy [26,27], by making suicide a central focus of clinical discourse and incorporating safety precautions and ongoing surveillance of suicide risk and resiliency factors, including MIL and additional psychological well-being variables [9].…”