Causes & Risk Factors

Possible Causes

The exact cause of self-neglect is unknown. However, researchers believe that it is related to one or more of the following factors:

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Old age and social isolation are risk factors for self-neglect

  • Decreased executive function/frontal lobe function
  • Poor social support,
  • Physical or mental disability,
  • Long-standing medical conditions,
  • Mental illness, and
  • Poor reasoning/dementia (Lien et al., 2016; Day, Leahy-Warren, & McCarthy, 2016).

One’s life experiences can also affect self-neglecting behavior (Lien et al., 2016; Paveza, VandeWeerd, & Laumann, 2008). The two most common experiences cited by individuals with self-neglect are traumatic loss of a loved-one and being a victim of violence (Lien et al ., 2016). Self-neglecting elders may not view themselves as having self-neglect (Day et al., 2016; Kutame, 2007; Bozinovski; 2000). This is true even when they are unable to perform essential tasks required to maintain independence. Individuals with self-neglect see themselves as trying to maintain their identity and control within the limits of failing physical and mental health (Day et al., 2016; Kutame, 2007). In other words, these individuals do not think of their condition as “self-neglect,” instead he or she may think of themselves as “self-care challenged” or “self-care disabled.”

Risk Factors

Self-neglect most often occurs in the elderly, especially in people over the age of 75 (Lauder & Roxburgh, 2012). It can also affect individuals with mental health problems like dementia, and long-standing alcohol abuse (Lee & LoGiudice, 2012). Self-neglect is more often in black, men, and people with low income (Day, Leahy-Warren, & McCarthy, 2016; Mosqueda & Dong, 2011)..  Self-neglect occurs more with social isolation, intelligence, and certain personality characteristics (Clark, Mankikar, & Gray, 1975; Macmillan & Shaw, 1966). Self-neglect has no preference for religion or region. It is not known if self-neglect is hereditary.

The following are risk factors for self-neglect:

  • Old age
  • Depression
  • Dementia
  • Poor memory, poor reasoning
  • Untreated mental health problems
  • Long-standing and untreated diseases
  • Poor diet resulting in low levels of vitamins and minerals
  • Alcohol and substance abuse
  • Needing help for routine daily activities, social support, and transportation,
  • Not wanting to be around anyone for long periods of time
  • Living alone
  • Mental confusion that can come and go
  • Poverty ( MacLeod, 2015; Lauder & Roxburgh, 2012; Day & Leahy-Warren, 2008; Dyer & Goins, 2000).

Personality Traits

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Self-neglecting individuals are typically described as unfriendly, stubborn, obstinate, aloof, aggressive, suspicious, secretive, and quarrelsome

Some personality traits are associated with the development of elder self-neglect (Dong et al., 2011). Elder self-neglect was described in a 1966 and used the term “senile breakdown syndrome” (Macmillan & Shaw, 1966). A pattern of personality characteristics in self-neglecting elderly was described.  Self-neglecting individuals are typically described as unfriendly, stubborn, obstinate, aloof, aggressive, suspicious, secretive, and quarrelsome (Macmillan & Shaw, 1966). These personality traits are viewed as a part of the typical presentation of self-neglect and may be risk factors for developing SN later in life (Macmillan & Shaw, 1966).

Commonly Described Risk Factors

Table 1 provides more details about some of the important risk factors commonly describing self-neglect (Day & Leahy-Warren,2008).

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Table 1: Risk factors for self-neglect

References

Bozinovski, S. D. (2000). Older self-neglecters: Interpersonal problems and the maintenance of self-continuity. Journal of Elder Abuse & Neglect, 12(1), 37–56.

Braye, S., Orr, D., & Preston-Shoot, M. (2015). Self-neglect and adult safeguarding: findings from research.

Clark, A. N. G., Mankikar, G. D., & Gray, I. (1975). Diogenes syndrome: a clinical study of gross neglect in old age. The Lancet, 305(7903), 366-368.

Day, M. R., Leahy-Warren, P., & McCarthy, G. (2016). Self-neglect: Ethical considerations. Annual Review of Nursing Research34(1), 89-107.

Day, M. R., & Leahy-Warren, P. (2008). Self-neglect 1: Recognizing features and risk factors. Nursing Times, 104(24), 26-27.

Dong, X., Simon, M., Wilson, R., Beck, T., McKinell, K., & Evans, D. (2011). Association of personality traits with elder self-neglect in a community-dwelling population. The American Journal of Geriatric Psychiatry, 19(8), 743-751.

Dyer, C. B., & Goins, A. M. (2000). The role of the interdisciplinary geriatric assessment in addressing self-neglect of the elderly. Generations24(2), 23.

Kutame, M. M. (2007). Understanding self-neglect from the older person’s perspective (Doctoral dissertation, The Ohio State University).

Lauder, W., & Roxburgh, M. (2012). Self‐neglect consultation rates and comorbidities in primary care. International Journal of Nursing Practice, 18(5), 454-461.

Lien, C., Rosen, T., Bloemen, E. M., Abrams, R. C., Pavlou, M., & Lachs, M. S. (2016). Narratives of self‐neglect: Patterns of traumatic personal experiences and maladaptive behaviors in cognitively intact older adults. Journal of the American Geriatrics Society, 64(11), e195–e200.

MacLeod, M. Z. K., & Douthit, K. Z. (2015). Etiology and management of elder self‐neglect. Adultspan Journal14(1), 11-23

Macmillan, D., & Shaw, P. (1966). Senile breakdown in standards of personal and environmental cleanliness. British Medical Journal, 2(5521), 1032–1037.

Paveza, G., VandeWeerd, C., & Laumann, E. (2008). Elder self‐neglect: A discussion of a social typology. Journal of the American Geriatrics Society56(s2), S271-S275.

Ungvari, G. S., & Hantz, P. M. (1991). Social breakdown in the elderly, II. Sociodemographic data and psychopathology. Comprehensive Psychiatry, 32(5), 445-449.


Last updated: March 13, 2017 at 18:42 pm by
I. M. Abumaria, AGPCNP-BC
Version 1.00