geriatrics
Self–Neglect in Older Adults
Introduction
Self-neglect is the inability or unwillingness of vulnerable adults to meet their basic needs themselves, thereby compromising the adult's well-being. It can include ignoring personal hygiene, not paying bills, not maintaining the integrity or cleanliness of the home, not obtaining or preparing food (leading to undernutrition), not seeking medical care for potentially serious symptoms, not filling prescriptions, not taking medications (prescription or over-the-counter) incorrectly, and skipping follow-up visits. Risk factors for self-neglectin older adults include Social isolation Disorders that impair memory or judgment (eg, Dementia ) The presence of multiple chronic disorders Substance misuse or abuse Severe depression Warning signs of self-neglectinclude lack of a caregiver plus any of the following: Rapid weight loss, undernutrition, dehydration Unaddressed health conditions Hypothermia or heat exhaustion Unsanitary home or unkempt clothing Lack of adequate food in the home Disconnected utilities Decubitus ulcers, poor hygiene, or unpleasant body odor Not taking medications Delirium Differentiating between self-neglect and simply choosing to live in a way that others find undesirable can be difficult. Social workers are often in the best position to make this determination. In the United States, Adult Protective Services or the state unit on aging (whose numbers are available through theEldercare Locatorat 800-677-1116) can help by coordinating in-home safety assessments and helping older people obtain counseling services, emergency response systems, referrals to additional support services, and, if necessary, hospitalization. 