Hope and Suicidal Ideation Among Older Adults Living in the Rural Mid-Hills of Nepal.

Objectives: The current study investigated whether hope and its two components (agency and pathways) weakened the relations between perceived burdensomeness, thwarted belongingness, and fearlessness about death and suicidal ideation among older adults living in rural Nepal.

Methods: A community sample of 300 people aged from 60 to 90 years (M_age = 67.07, SD_age = 6.23) who resided in the rural mid-hills of Nepal completed standardized measures.

Results: Hope and agency moderated the relationship between perceived burdensomeness and suicidal ideation and pathways moderated the relationship between thwarted belongingness and suicidal ideation.

Conclusions: Hope, and particularly agency, may play a protective role in reducing suicidal ideation among older Nepali adults living in rural areas who experience perceived burdensomeness. In contrast, pathways may be an additional risk factor for older adults experiencing unmet belongingness needs. Research is required to understand fearlessness about death and suicidality among older Nepali adults.

Clinical implications: Increasing hope and particularly agency may be associated with a reduction in suicidal ideation among older Nepali adults who experience feelings of being a burden. However, increasing pathways may be associated with an increase in suicidal ideation among those who experience unmet belongingness needs. Research is needed to understand how to accurately assess suicide risk among Nepali older adults.