An 80-year old-woman who lives alone has begun calling friends and complaining in an exaggerated

Question

fashion about minor aches and pains.

Her physician found no significant medical problems. Over the
course of a month, she obtained a number of prescriptions for pain medication, none of which
seemed to be effective. Friends counseled her that aches are a normal part of life for the elderly and
tried unsuccessfully to involve her in activities. She often suggested that she would be better off
dead, to which one friend responded "Well, perhaps. It would get you out of your misery.". As she
became increasingly "needy" and demanding of attention, friends agreed that her behavior made
them uncomfortable and began to call and visit less. The woman took four pain pills and called a
neighbor, saying she had overdosed. After medical clearance, the client will be monitored at the
mental health clinic. Principles of paramount importance to care planning in this instance include
(more than one answer may be correct):
A. Parasuicide with lethal intent requires emergency hospitalization.
B. The client should be treated for underlying psychiatric disorder if one exists.
C. Client perception of isolation is a significant cause for hopelessness.
D. A nonlethal suicide attempt must be viewed as communication of the client's desperate state of
mind.

Answer 1

B, D
Rationale: Option B: This client should be assessed for depression because 60% to 90% of elderly
suicides have at least one psychiatric diagnosis, two thirds of which are single-episode, late-onset
depression. The client's somatic symptoms may be depressive equivalents. Option D: Any suicide
attempt communicates the client's inability to find an acceptable solution to the problem. Option A:
The client's suicide attempt would not be considered parasuicide. Parasuicide is defined as a
nonfatal self-injury with a clear intent to cause bodily harm or death. Option C: Data are not present
to show that the client perceived self as isolated.