The Final Chapter: End-of-Life Decisions and Suicidal Risk


Living the last chapter of life can be difficult for patients and those who care for them. But, Dr. Pamela Steadman-Wood, a clinical geropsychologist at Providence VA, believes there is a special kind of beauty and a significant amount of bravery in facing end-of-life decisions and engaging in open discussions with people. relatives and providers.

“Veterans are very familiar with acts of bravery. And being able to open up to talking about death and dying is one of the most courageous acts of all time,” she said.

Suicidality vs hasty death wish

As veterans approach the end of their lives, it is normal to have thoughts of death and to die. For some, suicidal thoughts or the desire for a hasty death predominate. Providers are responsible for making this distinction to better inform interventions.

A veteran desiring a hastened death seeks control over the dying process and wishes to hasten his own death. This often occurs in response to suffering from a life-threatening illness. Veterans who have suicidal thoughts have suicidal thoughts and may be planning to die by suicide.

For providers, it is essential to recognize risk factors for suicide or accelerated death wish. Early detection facilitates appropriate interventions to help save Veteran lives.

“Some of the biggest predictors we see for suicide and the desire for accelerated death include depression, poor social supports and experiencing hopelessness,” said Dr. Kristen Dillon, clinical geropsychologist in hospice and palliative care at Bedford. GO. Pain and sleep problems can also contribute to an accelerated death wish and/or high risk of suicide.

Vendor support is available

The Suicide Risk Management (SRM) Counseling Program is a free resource to support providers in treating veterans at risk of suicide at the end of life.

SRM is a tool for suppliers to discuss risk assessment and other best practices. “Risk assessment is inherently a stressful experience. And then you add the complexities of the end of life, and you try to distinguish the desire for a hasty death from suicide. The consulting program can be an incredible asset as we providers navigate these nuances and support a veteran through their final chapter,” said Dillon.

In June, Steadman-Wood and Dillon will discuss suicide prevention and end-of-life as part of the monthly SRM lecture series. The lecture series takes place on the 2nd Wednesday of each month from 2-3 p.m. ET. Interested VAs and Community Providers can sign up here to learn more.

Ease the transition

VA and community partners offer an array of resources to help guide and support veterans as they enter the final chapter of their lives. Some sites to visit for more information and support include:

Help is always available. If you are a veteran in crisis or are concerned about a crisis, call the Veteran Crisis Line at 800-273-8255 and press “1” or text 838255.

The appearance of external hyperlinks does not constitute an endorsement by the Department of Veterans Affairs of the linked web sites, or of the information, products or services contained therein.


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