title: Social support and suicidal ideation in older adults using home healthcare services.
abstract: OBJECTIVE
  The objective of this study was to examine the associations between objective and subjective social support and suicidal ideation in older adults receiving home healthcare services.
  
  
  METHODS
  Participants were randomly selected from a sample of older adults newly starting skilled nursing care from a certified home health agency in Westchester County, NY. Research interviewers assessed 522 older adults aged 65 years and older who were receiving home care services. Subjective and objective components of social support were assessed using measures of social network, social interaction patterns, instrumental support, and perceptions of social support. Suicidal ideation was assessed using items from the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the Hamilton Depression Rating Scale.
  
  
  RESULTS
  In bivariate analyses, neither objectively determined size of social network nor instrumental support was associated with suicidal ideation. However, lower social interaction patterns and lower perceived social support were significantly related to suicidal ideation. After adjusting for potential confounders, only lower perceived support remained significantly associated with suicidal ideation. In post hoc analyses of the perceptions of social support scale items, satisfaction with one's relationships and feeling useful to family and friends were significantly associated with a lower likelihood of suicidal ideation in the final multivariate logistic regression model controlling for possible confounding variables.
  
  
  CONCLUSIONS
  Subjective social support is a potentially modifiable risk factor for suicide in later life. Findings suggest that the perception of social support is an important construct to examine in future longitudinal studies examining risk and protective factors for suicidal ideation and behaviors in older adults.
authors.affiliation: Weill Medical College of Cornell University, Institute of Geriatric Psychiatry, White Plains, NY, USA. jlr2006@med.cornell.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Rowe
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
authors.forename: Herbert C
authors.initials: HC
authors.lastname: Schulberg
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009518:New York / Q000453:epidemiology; D010549:Personal Satisfaction; D012307:Risk Factors; D012944:Social Support; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*