This study examines the phenomenon of intimate partner homicide-suicide (IPHS), specifically, how it differs (or not) from intimate partner homicide without suicide (IPH), and how the ages of victims and perpetrators shape the risks, vulnerabilities and contextual features of cases. A mixed methods document analysis of 232 domestic homicide reviews (DHRs) was undertaken, using bivariate analysis to compare 37 IPHS to 195 IPH-without suicide, and a gendered, thematic analysis to gain deeper, contextualized insights into IPHS structured by victim and perpetrator age. IPHS victims and perpetrators were older, and in the case of perpetrators, more likely to be white. Risks and vulnerabilities also differed, with less substance use, criminality, and violence, but greater physical and mental health difficulties. Themes of “Separation and loss,” “Dependency,” and “Mental health and suicidality” ran through the 37 IPHS, but with IPHS involving older adults appearing as phenomenologically distinct, shaped by gendered contexts of care and a loss of autonomy due to chronic, degenerative illness. Our findings highlight the key role for physical and mental health services—particularly General (Medical) Practitioners—alongside the need for comprehensive support systems and coordinated care to manage the complex interdependencies in elderly couples
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