Self-neglect is a major, unrecognized concern among older adults
Self-neglect is a major and often overlooked problem among older adults. In the United States, more than half of the cases of elder abuse reported each year are because of self-neglect, according the National Center on Elder Abuse.
“Self-neglect occurs when a person is not able to meet their own daily essential needs, due either to a physical or mental incapacity,” said Jennifer Matthews, nurse investigator in the Older Adult Protective Services (OAPS) department at Philadelphia Corporation for Aging (PCA).
Older adults who are experiencing self-neglect may stop bathing or cleaning up after themselves. They may stop taking medication or paying bills or avoid seeking necessary medical care. If left unaddressed, these behaviors may become entrenched and worsen over time.
According to Matthews, there are early warning signs of self-neglect. She encourages people to check on their friends, family and neighbors and take notice of changes in their status. She noted that people who are isolated or who have a substance abuse issue are particularly at risk.
“Sometimes things just don’t look right, or things look like they’re deteriorating, or there’s mail piling up outside of the home,” Matthews said. “There may be pets that aren’t taken care of. Sometimes there are hoarding issues.”
Physically, people that are self-neglecting might look disheveled, or they may become odorous. They may have visible wounds or refuse to use necessary medical devices like eyeglasses or hearing aids. There may also be changes in their weight from not eating or eating a poor diet.
Making a report
Someone who suspects self-neglect or any other form of elder abuse can call the PCA Helpline at 215-765-9040 to make a report 24/7. Matthews emphasized that reports can be made anonymously.
“People are protected under the law. They are confidential reporters. We do not release their name to anyone,” Matthews said. “We want people to feel free to be able to call and make a report if they have a concern.”
Matthews is quick to point out that people are helping, not harming, when they make a report for someone in need.
“I think there’s a misconception of protective [services] that we are going to go in and just pull someone out [of their home],” Matthews said. “They think that’s our role, but that’s not what we’re able to do; nor would we want to do that. We just want to keep people safe in the environment they want to be in, if that’s possible.”
To demonstrate that point, Matthews recalled an extreme case of self-neglect that she had experienced earlier in her career at PCA. A report came in about a veteran who was isolated in his apartment, where he had lived for many years. The man had stopped paying his bills and had very serious medical issues that were not being addressed. He had trouble walking and getting around.
“There were leaks in the apartment where wood was warped, and it was a very difficult situation,” Matthews said. “We had one of our medical providers help get him assessed medically. Then we got him hooked up with a regular doctor and the V.A. again,” she said.
Despite the man’s initial fears of losing his independence, he was able to continue living on his own. “The apartment manager—because we were involved and agreed to put in services—moved him into a new apartment in the same building,” said Matthews. “He started fresh with a brand new apartment that was not falling down around him. They really went above and beyond, I think, because they saw there was help for him and he wasn’t just going to another place and [have it] deteriorate. He cleared a little mentally and he followed up with the doctors, and it was a very successful story.”
The role of PCA’S Older Adult Protective Services department is to help detect, prevent, reduce or eliminate all forms of elder abuse, including self-neglect; neglect by a caregiver; physical, sexual or psychological abuse; misuse of the older adult’s money or personal property; and abandonment. Reports of elder abuse can be made anonymously 24/7 by calling PCA’s Helpline at 215-765-9040.
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