Self-Neglect

The perpetrator and the victim of self-neglect are one and the same.

Self-neglect occurs more often than mistreatment. Self-neglect is most likely to occur among older people who live alone and who isolate themselves. People who neglect themselves may have a disorder that impairs their judgment and memory or may have several chronic diseases. Some people, however, have no particular medical problems: It is unclear why such people engage in self-neglect.

The effects of self-neglect can range from poor personal hygiene to failure to seek care for a life-threatening condition. For example, a person may eat too little, which may lead to dehydration and malnourishment. He may refuse to seek treatment for a medical disorder or skip follow-up visits. He may lack the necessary clothing or other means with which to protect against extremes of hot and cold weather, yet choose not to seek help from others. The person's dwelling may be hazardous because of lack of basic maintenance or infestation by animal or insect pests.

Knowing where to draw the line between self-neglect and a person's right to autonomy and privacy can be very difficult for family, friends, and health care practitioners alike. The person may be making completely informed and capable choices. He may simply have elected to live in a way that others might find undesirable. Often, a social worker is in the best position to make such a determination and can intervene if alerted by the person's family or friends.

When the decision is made to intervene, help can be just a phone call away. Reporting self-neglect and seeking help for an affected person are done in much the same way as reporting elder mistreatment. The older person's primary care doctor should be contacted. Adult Protective Services or the state unit on aging (whose numbers are available through the Eldercare Locator at 800-677-1116) can be contacted as well.