State Definitions, Laws, and Processes
Although the Federal Elder Justice Act of 2010 defines self-neglect, each state still has their own laws and processes. Not every state includes self-neglect under APS, but most do (Quinn, 2011). The National Adult Protective Services Association (NAPSA) has adopted its own definition of self-neglect. However, not all US state laws contain all components of this definition (NAPSA, n.d.). In most states, self-neglect is included under the definition of elder abuse (Teaster, Dugar, Mendiondo, Abner, Cecil, & Otto, 2006). Some states, such as Texas, do not distinguish between self-neglect and neglect by others (Choi, Kim, & Asseff, 2009). Other states may use the term “vulnerable adult” when referring to an individual with self-neglect (Ohio Department of Job and Family Services, 2013).
Mandatory reporting by healthcare providers is required in all 50 states. Self-neglect is not prosecuted (Connolly, 2008).
In Texas code, neglect is defined as “the failure to provide for one’s self the goods or services, including medical services, which are necessary to avoid physical or emotional harm or pain or the failure of a caretaker to provide such goods or services”(Human Resources Code Chapter 48, n.d.).
In Texas, how self-neglect is managed depends on the age of the person. For adults 18 to 64 years of age, a person suspected of having self-neglect must have been diagnosed or have an established mental, physical, medical, or developmental disability that regularly reduce their ability to perform essential self-care tasks and protection (Burnett et al., 2014). In other words, the term self-neglect only applies to people over the age 65 or an adult who has an established disability. Therefore, adults that do not fall in these categories are not considered to have self-neglect, at least not in the state of Texas.
Individual Rights in Texas
In Texas Human Resources Code, Chapter 48, a person receiving protective services has the right to:
- Refuse protective services, unless the person is incompetent and is in a life-threatening situation;
- Receive the full protection and safety that APS can provide;
- If able to, participate in management decisions;
- Select solution with the least restrictions;
- Refuse medical treatment that conflicts with religious beliefs; and
- Have a court-appointed attorney to represent their best interest in legal matters (Texas Department of Family and Protective Services, n.d.).
In Florida, neglect is “the failure or omission on the part of the caregiver or vulnerable adult to provide the care, supervision, and services necessary to maintain the physical and mental health of the vulnerable adult, including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services, which a prudent person would consider essential for the well-being of a vulnerable adult. The term ‘neglect’ also means the failure of a vulnerable adult to make a reasonable effort to protect themselves from abuse, neglect or exploitation by others. ‘Neglect’ is repeated conduct or a single incident of carelessness, which produces or could reasonably be expected to result in serious physical or psychological injury, or a substantial risk of death” (Florida Department of Children and Families, n.d.).
The law in Florida requires the reporting of known or suspected cases of self-neglect of older adults and adults with disabilities (Florida Department of Children and Families, 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.
Choi, N. G., Kim, J., & Asseff, J. (2009). Self-neglect and neglect of vulnerable older adults: Reexamination of etiology. Journal of Gerontological Social Work, 52(2), 171-187.
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.
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
National Adult Protective Services Association. (n.d.d). What is neglect? Retrieved from http://www.napsa-now.org/get-informed/what-is-neglect/
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.
Ohio Department of Job and Family Services. (2013). Ohio Coalition for Adult Protective Services: A Statewide Partner. Retrieved from http://jfs.ohio.gov/PFOF/PDF/FF-20160603.stm
Quinn, K. (2011). Adult abuse and self-neglect: What are they & what is being done about them? http://www.nasuad.org/documentation/hcbs2011/Presentations/M2RegencyD.pdf
Teaster, P. B., Dugar, T. A., Mendiondo, M. S., Abner, E. L., Cecil, K. A., & Otto, J. M. (2006). The 2004 survey of state adult protective services: Abuse of adults 60 years of age and older. Washington, DC: The National Center on Elder Abuse. Retrieved on August, 26(2010), 16-16.
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
Last updated: June 7, 2020 at 16:39 pm by
I. M. Abumaria, Doctor of Nursing Practice