# How to Prevent Suicide in Older Patients with a Neurocognitive Disorder: A Scoping Review Leading to the Development of a Clinical Guide for Healthcare Workers

## TL;DR

This paper presents a clinical guide developed to help healthcare workers prevent suicide in older patients with neurocognitive disorders.

## Contribution

The novel contribution is a practical clinical guide based on a scoping review and feedback from professionals.

## Key findings

- The guide helps professionals assess suicide risk and unmet needs in older adults with NCD.
- Feedback from professionals showed the guide dispels misconceptions about suicide risk in this population.
- Organizational barriers are the main challenge in implementing the guide.

## Abstract

Background/Objective: Healthcare professionals working with individuals living with neurocognitive disorders (NCD) express the need for training to prevent suicidal behaviors in this population. Accordingly, this paper describes the process used to develop a suicide prevention clinical guide for use in geriatric care settings. Methods: The project involved three steps. First, a team of researchers conducted a scoping review of empirical studies on suicide among older adults with NCD, focusing on prevalence, risk and protective factors, assessment and practical interventions. Secondly, based on these findings, the team created a clinical guide that helps healthcare professionals assess needs and suicide risk and formulate action plans to improve well-being, ensure safety, and reduce the risk of suicide. Result: The guide was finalized after 18 months of deliberation. It enables professionals to structure their evaluation, so that no relevant aspect is overlooked, and protective factors are reinforced. It emphasizes shared responsibilities and interdisciplinary collaboration. It recommends that professionals conduct a personalized clinical assessment of unmet needs to reduce distress. During the third step, the guide was evaluated through a pilot study, involving post-training focus groups and interviews with professionals who used it in clinical practice. Conclusions: Participants’ feedback was integrated into the final version of the Guide, and the results indicated that it helped dispel misconceptions about the low risk of suicide among patients with NCD, whose suicidality is frequently misinterpreted as mere disruptive behavior. Organizational barriers represent the main challenge professionals may face when using the Guide.