Self-neglect is the inability or unwillingness of vulnerable adults to meet their basic needs themselves, thereby compromising the adult's well-being. It can include ignoring personal hygiene, not paying bills, not maintaining the integrity or cleanliness of the home, not obtaining or preparing food (leading to undernutrition), not seeking medical care for potentially serious symptoms, not filling prescriptions, not taking medications (prescription or over-the-counter) incorrectly, and skipping follow-up visits.
Risk factors for self-neglect in older adults include
Social isolation
Disorders that impair memory or judgment (eg, dementia)
The presence of multiple chronic disorders
Substance misuse or abuse
Severe depression
Warning signs of self-neglect include lack of a caregiver plus any of the following:
Rapid weight loss, undernutrition, dehydration
Unaddressed health conditions
Hypothermia or heat exhaustion
Unsanitary home or unkempt clothing
Lack of adequate food in the home
Disconnected utilities
Decubitus ulcers, poor hygiene, or unpleasant body odor
Not taking medications
Delirium
Differentiating between self-neglect and simply choosing to live in a way that others find undesirable can be difficult. Social workers are often in the best position to make this determination.
In the United States, Adult Protective Services or the state unit on aging (whose numbers are available through the Eldercare Locator at 800-677-1116) can help by coordinating in-home safety assessments and helping older people obtain counseling services, emergency response systems, referrals to additional support services, and, if necessary, hospitalization.
