Ensuring the proper care of a loved one who is aging or has a disability can be challenging, regardless of circumstances. When the person lives alone or has physical or cognitive decline, such as dementia, and thus is unable to care for him or herself, the challenge is far greater. If your loved one has a health condition or is socially isolated, he or she may be at risk of self-neglect. It can happen knowingly or unknowingly. Knowing where to draw the line between a person’s right to independence and self-neglect can be hard.
The Administration for Community Living defines self-neglect as the failure of an adult to provide him or herself with basic needs such as personal hygiene, food, shelter and medical care, which in turn threatens the person’s safety or health. The following signs indicate that your loved one may be self-neglecting and it may be time to intervene:
— A lack of basic hygiene
— Failure to seek necessary medical care or take essential medications
— Malnourishment
— Going without heat, water or electricity in the home
— Not wearing suitable clothing for the weather
— Confusion
— Living in an environment of extreme hoarding or clutter
— Inability to attend to housekeeping
— Dehydration
— Leaving a burning stove unattended
According to research studies, about 9% of older adults are victims of self-neglect. Self-neglect is the most commonly reported type of abuse to Adult Protective Services, making it 64% of all cases. Self-neglect has also been proven to increase a person’s risk for nursing home placement, premature death, increased hospitalization and increased use of emergency services.
Here are some tips for talking to an individual with self-neglect.
Be gentle. Let the person tell his/her story.
Respect the person and the items that may be hoarded.
Remain calm, caring and supportive.
Use facts, not emotions. Don’t be critical or judgmental, and don’t make negative comments.
Point out items, conditions, or situations that are unsafe. (And check whether pets have been neglected).
Don’t force the individual to do something, or talk about something that makes them uncomfortable.
Don’t talk about the person as if they are not there.
The individual is more likely to talk if they feel that you are being supportive. Consider starting a conversation about self-neglect by talking about common interests or general topics to help make the person more comfortable. Showing that you understand and care builds trust. Try to get a sense of when things began to change. Often they do not see or view their situation as one of self-neglect.
Talking to someone with self-neglect requires patience and understanding. Start by contacting Adult Protective Services (APS) and/or the health care provider if you think there is self-neglect.
Adult Protective Services can be contacted by phone. After getting the report, an APS worker may investigate via a face-to-face interview with your loved one. The interview will include an assessment to determine whether self-neglect is actually taking place. The APS worker will offer referrals to community-based resources such as home care services, and may also seek the help of various professionals such as doctors or other health care providers and law enforcement officers to develop a care plan to keep your loved one in a safe environment.
APS workers are trained to respect the wishes of every individual. In some cases, your loved one will have the right to decline services. This is the case unless a judge has decided, after considering evidence presented by a licensed health care practitioner, that your loved one cannot legally make his or her own decisions.
If you witness a life-threatening situation involving a senior or adult with disabilities, immediately call 911.
Maureen A. Wendt is president and CEO of The Dale Association, a non-profit organization that provides senior, mental health, in-home care, caregiver support services and enrichment activities for adults. For more information, call 433-1937 or visit www.daleassociation.com .
