The suicide rate among U.S. elderly (age 65 and older) is higher than in any other age group. Severe and recurrent mood disorders, particularly unipolar and bipolar depression, are associated with the highest suicide risk. Medical conditions linked to a higher risk of suicide include severe pain, visual impairment, neurological illness, and malignancy. The combination of improved detection of depression with collaborative treatment, including antidepressants and manualized psychotherapy, is currently the best-supported strategy for suicide prevention in the elderly, but evidence remains limited. Telephone support and emergency alarm service also have promise. In younger adults and mixed-age samples, lithium and electroconvulsive therapy were shown to decrease long-term and short-term suicide risk, respectively, in individuals with severe mood disorders. In most studies, cloza-pine was demonstrated to reduce suicidal behaviors in persons with schizophrenia. These treatments also are eff

Post-fall assessment is an essential component of any fall prevention intervention. Typically, clinical practice recommendations for fall assessment are left to the discretion of each practitioner and often overlook many of the associated symptoms, situational contexts, and pertinent elements required to reveal likely underlying determinants of a fall event. In order to elicit a comprehensive evaluation of a recent fall, a five-step organizational approach is presented, which allows for the consistent gathering of key information needed to determine possible underlying fall etiology, while also addressing the person’s perception of his or her fall. Several cases will be used to illustrate this comprehensive approach to fall assessment. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[12]:16-24)

Disruptive behaviors such as agitation and aggression are a significant concern among elderly persons with dementia. Physical and pharmacologic restraints, commonly used to manage disruptive behaviors, are often not well tolerated by the elderly. Therefore, there is a need to explore alternative methods of managing these behaviors. Musical cognitive ability may be preserved in elderly individuals with dementia, and music intervention is a relatively simple, noninvasive, and inexpensive intervention for disruptive behaviors. This article will review literature examining the impact of music intervention on disruptive behaviors in long-term care residents with dementia. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[12]:33-36)