Self-Care

To understand self-neglect, one must first understand the opposite of self-neglect, self-care. Self-care includes adequate food and drink, exercise, rest, social interaction, and activities of daily living (Renpenning & Taylor, 2011; Hardy, 2011).

The living room of a person with self-neglect

More self-care activities required for well-being include:

• Movement:
  • Moving to and from bed
  • Moving around the house,
  • Going to the store and other
  • Going to outside activities such as church
• Personal care:
  • Washing the body
  • Dressing
  • Preparing food and eating
  • Brushing  teeth and combing hair
  • Using the restroom
• Maintaining the house
  • cleaning  the house
  • caring for pets
  • Using pest control services when needed
• Having transportation when needed

The Various Definitions of Self-Neglect

Self-neglect occurs when self-care is not performed. However, there is no widely accepted definition for self-neglect. A commonly cited definition for self-neglect is by Gibbons. Gibbons states that self-neglect is “the inability (intentional or non-intentional) to maintain a socially and culturally accepted standard of self-care with the potential for serious consequences to the health and well-being of the self-neglecter and perhaps even to their community” (Gibbons, Lauder, & Ludwick, 2006, p. 16).  Self-neglect involves seniors or adults with disabilities who fail to meet their own essential physical, psychological or social needs. When one fails to meet these needs, his or her health and safety become threatened.  This includes failure to provide adequate food, clothing, shelter and health care for one’s own needs According to National Adult Protective Services Association, n.d.).

Brushing your teeth is an example of an Activity of Daily Living

Another definition for self-neglect “is failure to provide for one’s own essential needs”(National Committee for the Prevention of Elder Abuse [NCPEA], n.d.). Self neglect refers to situations in which there is outside person to commit the neglect. Self-neglect results when the person refusing care (NCPEA, n.d.).

The law defines 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 person who has the mental capacity and who understands the consequences of his or her decisions. Despite understanding how an individual behavior would affect health, the individual makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice (Day, Leahy-Warren, & McCarthy, 2016).

Signs and symptoms of self-neglect include but are not limited to:

• Dehydration, malnutrition, untreated medical conditions, and poor personal hygiene
• Unsafe living conditions/arrangements. they may have improper wiring, no plumbing, no heat or running water
• Unclean living environment like animal/insect infestation, no functioning toilet, fecal/urine smell
• Inadequate clothing and lack of the necessary medical aids like eyeglasses, hearing aids and dentures
• They may be living in unsafe house or may be homelessness (National Center on Elder Abuse, n.d.).

Attributes and Criteria

Whichever definition is used, the following behaviors  are usually included or implied when identifying self-neglect:

It is unknown how to prevent self-neglect

• Behaviors that are harmful to life and health;
• The self-neglecting individual gives no reason for engaging in the behaviors;
• The individual does not intend for the behaviors to end his or her life;
• The effects of the behaviors can only be appreciated over a long period of time;
• The individual continuously performs behaviors that affect several aspects of their life;
• The individual does not clean their body, clothes, possessions, and house, to the point of living in filth;
• The individual constantly refuses help/services that could improve their quality of life;
• The individual makes bad decisions and chooses unsafe behaviors that place them at risk of harm. For example, he or she may refuse to take important medications (O’Brien, Thibault, Turner, & Laird-Fick, 2000).

In practice, a commonly used criterion for identifying self-neglect is when at least one of the behaviors is in Table 1 is encountered.

Table 1: A commonly used criterion  for identifying self-neglect (Pavlou & Lachs, 2008)

Prevention of Self-Neglect

It is not known whether self-neglect can be prevented. There is also no research evidence to support the benefits of early intervention in self-neglect. Controlled studies are needed, especially to show whether early diagnosis followed by increased social support and tailored health care services have an effect on outcomes (Papaioannou, Räihä, & Kivelä, 2012). See Prevention of Elder Abuse for tips on preventing elder abuse in general.

Last updated: June 6, 2020 at 15:19 pm by
I. M. Abumaria, Doctor of Nursing Practice
Version 2.00