“Senile Breakdown” was the term initially used to describe what is currently known as self-neglect (Macmillan & Shaw, 1966). The condition described 50 years ago is still accurate today: “She, her garments, her possessions, and her house are filthy. She may be verminous and there may be feces and pools of urine on the floor” (Macmillan & Shaw, 1966, p. 1032). Over the following years, the terminology became confusing, with the condition variously being called:
- 1966: Senile breakdown — (Macmillan & Shaw, 1966)
- 1975: Diogenes syndrome — (Clark, Mankikar, & Gray, 1975)
- 1977: Elder self-neglect — (Roe, 1977)
- 1991: Social breakdown — (Ungvari & Hantz, 1991)
- 1998: Senile squalor syndrome — (Clark, 1998)
- 2000: Litter hoarding syndrome — (Jürgens, 2000)
- 2004: Messy house syndrome — (Barocka, Seehuber, & Schone, 2004)
- 2006: Intentional and nonintentional subtypes of self-neglect — (Gibbons, Lauder, & Ludwick, 2006)
- 2014: Four subtypes of elder self-neglect described: Physical and medical, environmental, global, and financial — (Burnett et al., 2014)
There is still not a complete understanding of self-neglect after more than 50 years of study, It remains unclear whether self-neglect is a distinct syndrome or represents a collection of mental illnesses that have overlapping signs and symptoms (Esposito, Corruble, & Hardy, 2006; Halliday, Banerjee, Philpot, & Macdonald, 2000). Previously, each case of possible SN had to be assessed by a doctor (Clark et. al., 1975). Beginning in the mid-2000’s, screening tools for self-neglect starting to be developed (Naik, Pickens, Burnett, Lai, & Dyer, 2007). Today, self-neglect screening tools are actively used in the field by health care providers (Torbay Safeguarding Adults, 2016). Validation of these screening tools is ongoing (Day, Leahy-Warren, & McCarthy, 2016; Day & McCarthy, 2016).References
Barocka, A., Seehuber, D., & Schone, D. (2004). Messy house syndrome. MMW Fortschritte der Medizin, 146(45), 36-39.
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.
Cipriani, G., Lucetti, C., Vedovello, M., & Nuti, A. (2012). Diogenes syndrome in patients suffering from dementia. Dialogues in Clinical Neuroscience, 14(4), 455–460
Clark, J. (1998). The challenge of senile squalor syndrome. Geriatric Medicine-London, 28, 41-46.
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 Research, 34(1), 89-107.
Day, M. R., & McCarthy, G. (2016). Self-neglect: Development and evaluation of a self-neglect (SN-37) measurement instrument. Archives of Psychiatric Nursing, 30(4), 480-485.
Esposito, D., Corruble, E., & Hardy, P. (2006). Could self‐neglect in older adults be a geriatric syndrome?. Journal of the American Geriatrics Society, 54(12), 1946-1946.
Gibbons, S., Lauder, W., & Ludwick, R. (2006). Self‐Neglect: A proposed new NANDA diagnosis. International Journal of Nursing Terminologies and Classifications, 17(1), 10-18.
Halliday, G., Banerjee, S., Philpot, M., & Macdonald, A. (2000). Community study of people who live in squalor. The Lancet, 355(9207), 882-886.
Jürgens, A. (2000). Refuse hoarding syndrome. Psychiatrische Praxis, 27(1), 42-46.
Macmillan, D., & Shaw, P. (1966). Senile breakdown in standards of personal and environmental cleanliness. British Medical Journal, 2(5521), 1032–1037.
Mark, J. (2014). Diogenes of Sinope. Retrieved from http://www.ancient.eu/Diogenes_of_Sinope/
Naik, A. D., Pickens, S., Burnett, J., Lai, J. M., & Dyer, C. B. (2007). Assessing capacity in the setting of self-neglect: Development of a novel screening tool for decision-making capacity. Journal of elder Abuse & Neglect, 18(4), 79-91.
Pavlou, M. P., & Lachs, M. S. (2008). Self-neglect in older adults: A primer for clinicians. Journal of General Internal Medicine, 23(11), 1841-1846.
Roe, P. F (1977). Self-neglect. Age Ageing, 6(3), 192-194.
Torbay Safeguarding Adults (March 16, 2016). Self-neglect screening tool. Retrieved from http://www.torbayandsouthdevon.nhs.uk/uploads/adults-journey-self-neglect-initial-screening-tool.pdf
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: by
I. M. Abumaria, AGPCNP-BC