There is no international legal definition for self-neglect. Perception, managed, and treatment of self-neglect varies from country-to-country and state-to-state (McDermott, 2010; Working Group on Elder Abuse, 2002; National Adult Protective Services Association, n.d.). For instance, the United States classifies self-neglect as a form of elder abuse. Ireland, Scotland, United Kingdom (UK), and Australia do not (Day, Leahy-Warren, & McCarthy, 2016; Lauder, 1999; McDermott, 2010). In Ireland, there is no mandatory reporting of elder abuse. (Day et al., 2016). On March 11, 2016, the UK updated the Care Act Statutory Guidance, which covers individuals with self-neglect (Department of Health, 2016).
The various approaches to self-neglect makes performing and interpreting research difficult (O’Brien, Thibault, Turner, & Laird-Fick, 1999). The lack of a standardized definition also makes it difficult to form appropriate international guidelines for detection and intervention of self-neglect (Fulmer, 2008).
US Federal Law
It was not until 1987 that a federal definition of elder abuse first appeared in the Amendments to the Older Americans Act (National Center on Elder Abuse [NCEA], n.d.). In 2010, Congress passed the Elder Justice Act as part of the Affordable Care Act (Day et al., 2016). The Act provides the current federal definition of self-neglect as: “An adult’s inability, due to physical or mental impairment, or diminished capacity, to perform essential self-care tasks including: (A) obtaining essential food, clothing, shelter, and medical care; (B) obtaining goods and services necessary to maintain physical health, mental health; or (C) managing one’s own financial affairs” (42 U.S.C. § 3002). This definition excludes a mentally competent individual who understands the consequences of his or her decisions (Day et al., 2016).
Unfortunately the Elder Justice Act has received only limited federal funding from congress since it was created (Colello, 2017). Federal definitions of self-neglect are only considered guidelines. Each state determines its own self-neglect definitions, laws, management, and treatments [NCEA], n.d.).References
Burnett, J., Dyer, C. B., Halphen, J. M., Achenbaum, W. A., Green, C. E., Booker, J. G., & Diamond, P. M. (2014). Four subtypes of self‐neglect in older adults: Results of a latent class analysis. Journal of the American Geriatrics Society, 62(6), 1127-1132.
Colello, K. J. (2017). The Elder Justice Act: Background and Issues for Congress. Washington DC: Congressional Research Services. Retrieved from https://fas.org/sgp/crs/misc/R43707.pdf
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.
Day, M. R., Leahy-Warren, P., & McCarthy, G. (2016). Self-neglect: Ethical considerations. Annual Review of Nursing Research, 34(1), 89-107.
Department of Health. (2016, December 9). Care and support statutory guidance. Retrieved from https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance
Florida Department of Children and Families. (n.d.). Adult Protective Services. Retrieved on http://www.myflfamilies.com/service-programs/adult-protective-services
Fulmer, T. (2008). Barriers to Neglect and Self‐Neglect Research. Journal of the American Geriatrics Society, 56(s2), S241-S243.
Human Resources Code Chapter 48. (n.d.). Investigations and protective services for elderly persons and persons with disabilities. Retrieved December 31, 2016, from http://www.statutes.legis.state.tx.us/Docs/HR/htm/HR.48.htm
Mcdermott, S. (2010). Professional judgements of risk and capacity in situations of self-neglect among older people. Ageing and Society, 30(06), 1055-1072.
National Adult Protective Services Association. (n.d.d). What is neglect? Retrieved from http://www.napsa-now.org/get-informed/what-is-neglect/
National Center on Elder Abuse. (n.d.). Frequently asked questions. Retrieved from https://ncea.acl.gov/faq/#faq1
O’Brien, J. G., Thibault, J. M., Turner, L. C., & Laird-Fick, H. S. (1999). Self-neglect: An overview. Journal of Elder Abuse & Neglect, 11(2), 1-19.
Texas Department of Family and Protective Services. (n.d.). In-home investigations and services. Retrieved from http://www.dfps.state.tx.us/Adult_Protection/About_Adult_Protective_Services/in_home.asp
Working Group on Elder Abuse. (2002). Protecting our future: Report of the Working Group on elder abuse. Retrieved from http://www.ncaop.ie/publications/research/reports/73_ProtectingourFuture.pdf
Last updated: February 25, 2017 at 21:24 pm by
I. M. Abumaria, AGPCNP-BC