Most cases of self-neglect come to the attention of Adult Protective Services late, when it has already become a longstanding problem. In fact, most of cases present in an extreme state of personal and environmental deterioration (O’Brien, Thibault, Turner, & Laird-Fick, 1999).
Self-Neglect Not Reported
There are many reasons why reporting self-neglect is delayed. Self-neglect may develop so slowly that it is not recognized until there is a crises. Self-neglect may be considered a taboo; reporting may be avoided for fear of stigmatizing the family name and negative views by the community. Fear of how reporting will affect the relationship with the loved one may also play a part. All of these aspects of self-neglect has not undergone any scientific research, so it is hard to know what role they play.
Worried About Reporting Self-Neglect discusses the benefits to reporting, what to do if you are not sure if the individual has self-neglect, and legal protections for those who report.
Who Should Report Self-Neglect?
Everyone who is aware of self-neglect should report it. Mandatory reporting by healthcare providers is required in all 50 states. (Connolly, 2008). However, reports can also be made by other professionals like the police, mail handlers, fire agents, and city code inspectors (Arizona Attorney General Mark Brnovich, n.d.). If you are a neighbor or friend, you should report suspicious behavior. If you are uncomfortable about using your name, you can report anonymously.
What Can You Do to Help?
Support from family/friends, neighbors, and community members is necessary to keep older adults safe in the community (Washington State Department of Social and Health Services, n.d.). The most common reasons for reporting self-neglect include lack of utilities, an unsafe environment, cognitive disorders, questionable medication adherence, capacity evaluation, and poor personal hygiene. In most cases, only one of these reasons caused someone to make a report. One-third of cases reported two reasons. Less than 10% reported 3 (Dyer, Pickens, & Burnett, 2007).
Family/friends can provide the older adult with help and reduce isolation. For example, community services (e.g., friendly visiting, regular telephone calls, and volunteer driving) may help reduce isolation of vulnerable adults. They should stay in contact with their loved one, talk and listen to the person.
For those that do have self-neglect, allowing the individual to express how they feel may help them to see solutions. The options available need to be reviewed with the individual. Their wishes need to be recognized. Family/friends can help the person to accept help from others. A person with self-neglect may find it difficult to rely on others for help. So, the family can help the individually by helping them get the services they need. They can seek advice from the primary care provider and Adult Protective Services. Always remember that vulnerable persons may choose a lifestyle different from yours. Respect his or her choice when attempting to help.
Neighbors need to be on the lookout for any sudden changes that might indicate a problem with an older neighbor (National Committee for the Prevention of Elder Abuse [NCPEA], 2008). For example, look to see if the newspapers are piling up or if the pets are not cared for. See if the individual is behaving differently from his or her normal routine. If you suspect a problem or you have concerns, go over and ask if that individual is okay. Don’t be shy or think you are intruding; you are concerned for the person’s well-being.
The individual is more likely to accept your support and answer your questions than if an agency or law enforcement is involved (NCPEA, 2008). Always listen to the person and offer your support. Seek help from your local Adult Protective Services office. If you feel the person is in danger or needs immediate medical attention, call 911.
Mail carriers, utility workers, and other service providers are all part of the community. They can be on the lookout for any subtle changes that might indicate a problem with an aging customer. Look for signs that may indicate the person may need help. If you have concerns, knock on the door and ask. The worst can happen is that person will ask you to leave. Law enforcement and social service agencies cannot be everywhere and they need your help (NCPEA, 2008). If the person does not answer the door and you are concerned for their safety, call 911 and ask for a welfare check (NCPEA, 2008).
Since each state has its own laws, please check your state on the process of reporting and follow up.References
Arizona Attorney General Mark Brnovich. (n.d.b). Elder abuse information and training guide. Retrieved from https://www.azag.gov/seniors/elder-abuse-information-and-training-guide#9
Connolly, M. T. (2008). Elder Self‐Neglect and the Justice System: An essay from an interdisciplinary perspective. Journal of the American Geriatrics Society, 56(s2), S244-S252.
Dyer, C. B., Pickens, S., & Burnett, J. (2007). Vulnerable elders: when it is no longer safe to live alone. The Journal of the American Medical Association, 298(12), 1448-1450.
O’Brien, J. G., Thibault, J. M., Turner, L. C., & Laird-Fick, H. S. (2000). Self-neglect: An overview. Journal of Elder Abuse & Neglect, 11(2), 1-19.
Washington State Department of Social and Health Services. (n.d.). Self-neglect. Retrieved from https://www.dshs.wa.gov/altsa/home-and-community-services/self-neglect
Last updated: June 7, 2020 at 16:41 pm by
I. M. Abumaria, Doctor of Nursing Practice