Objectives: The aims of this study were: (i) to investigate the proportion of older people writing suicide
notes in New Zealand; (ii) to compare the socio-demographic and clinical variables of older suicide note
writers and non-note writers; and (iii) to perform a thematic analysis of the content of suicide notes.
Methods: The Coronial Services provided records of all suicide cases aged 65 years and over (n¼225)
between July 2007 and December 2012. We were able to determine whether there was a suicide note
written in 212 cases. The content of 39 coroners/medical examiners’ excerpts and 5 suicide notes was
available for thematic analysis using a general inductive approach.
Findings: 88 (41.5%) older people left a suicide note. Logistic regression showed that female gender
(OR¼2.8, 95% CI¼1.45.7, p¼0.005) and Caucasian ethnicity (OR¼13.7, 95% CI¼1.7111.0, p¼0.014)
are significantly associated with older people writing suicide notes. 33.3% of those who left a suicide note
gave health-related reasons for their suicide and a significant proportion (73.3%) of them had underlying
medical conditions. Another common theme is around people leaving specific instructions and wishes.
Conclusions: Apart from gender and ethnicity, suicide note writers are similar to non-writers on broad
socio-demographic and clinical factors. Suicide notes indicated free will in and reasons for their suicide
and emotional/farewell messages to their loved ones. Many documented poor quality of life or physical
illness but the progression of these factors to suicide in older people should be further researched.