Self Neglect

Understanding self neglect is helpful when preventing neglect and abuse. If your loved one is in a home, you might notice signs of neglect. But, the staff taking care of your loved one might not have caused this. You need to get more information before making accusations. This information will be provided for you here.

What is Self Neglect?

Self neglect sometimes presents itself as neglect among the elderly. It happens when a person, by choice or lack of awareness or ability, disregards their health. It can also include when an older person refuses needed care or help with daily activities. Elderly people might self neglect themselves because they don’t like where they are. If they want to get out, they can tell their family they are being neglected and can’t stay there. Also, oftentimes their loved one will move them out right away. If the elderly person has a home health aide, that person might get replaced.

Examples of self neglect include inadequate personal hygiene, not taking needed medication, poor and unsafe living conditions, lack of heat, and lack of nutrition. In addition, self neglect may occur with other issues. Other common issues include alcohol or drug problems, mental health challenges or dementia. Those who self neglect face higher risk for falls, medication errors, isolation and depression. You will want to watch out for your loved one to make sure that they are not neglecting themselves. They might even be doing it without knowing. So, check up on them often to make sure they are doing ok and that they have not caused themselves any harm.

Neglect can be intentional (active) or unintentional (passive). Intentional or active neglect occurs when a caregiver knowingly and intentionally fails to provide an older person with basic necessities or care. Then, unintentional or passive neglect occurs when a caregiver unknowingly fails to provide basic necessities or care. There are a number of reasons for this, such as the caregiver’s lack of experience, information or ability.

Neglect involves a failure to provide an older person with necessities and care basic needs such as food, water, housing, clothing, or heat; appropriate hygiene and personal care; medical care or access to medical care; necessary health aids or equipment for daily living such as wheelchairs, hearing aides, walkers, canes, or grab bars; a clean and safe place to live; transportation to and from necessary appointments; or access to friends, family, or companionship inside or outside the home.

Neglect can also include leaving a vulnerable older person alone for too long; failing to provide adequate supervision or safety precautions, abandonment, or mismanagement of medication. Indicators of neglect are malnourishment; unkempt appearance; untreated medical conditions; missing dentures, glasses or hearing aids; or lack of heat or electricity.

There are ways for you to notice if your loved one is being neglected. In addition, indicators of neglect include the condition of the older person’s home environment, physical signs of poor care, and behavioral characteristics of the caregiver and/or older person.

Also, some of the indicators listed below may not signal neglect but rather reflect lifestyle choices, lack of resources, or mental health problems, etc. One should look for patterns or clusters of indicators that suggest a problem.

Signs of Neglect Observed in the Home

• Absence of necessities including food, water, heat.
• Inadequate living environment evidenced by lack of utilities, sufficient space, and ventilation.
• Animal or insect infestations.
• Signs of medication mismanagement, including empty or unmarked bottles or outdated prescriptions.
• Housing is unsafe as a result of disrepair, faulty wiring, inadequate sanitation, substandard cleanliness, or architectural barriers.

Physical Indicators

• Poor personal hygiene including soiled clothing, dirty nails and skin, matted or lice infested hair, odors, and the presence of feces or urine.
• Unclothed, or improperly clothed for weather.
• Decubiti (bedsores).
• Skin rashes.
• Dehydration, evidenced by low urinary output, dry fragile skin, dry sore mouth, apathy, lack of energy, and mental confusion.
• Untreated medical or mental conditions including infections, soiled bandages, and unattended fractures.
• Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or commodes.
• Exacerbation of chronic diseases despite a care plan.
• Worsening dementia.

Behavioral Indicators

Observed in the caregiver/abuser:

• Expresses anger, frustration, or exhaustion.
• Isolates the elder from the outside world, friends, or relatives.
• Obviously lacks care giving skills.
• Is unreasonably critical and/or dissatisfied with social and health care providers and changes providers frequently.
• Refuses to apply for economic aid or services for the elder and resists outside help.

Observed in the victim:

• Exhibits emotional distress such as crying, depression, or despair.
• Has nightmares or difficulty sleeping.
• Has had a sudden loss of appetite that is unrelated to a medical condition.
• Is confused and disoriented (this may be the result of malnutrition).
• Is emotionally numb, withdrawn, or detached.
• Exhibits regressive behavior.
• Exhibits self-destructive behavior.
• Displays fear toward the caregiver.
• Expresses unrealistic expectations about their care (e.g. claiming that their care is adequate when it is not or insisting that the situation will improve).

Being able to identify the difference between self neglect and neglect can save you a lot of work. If it is just self neglect, you can talk with your loved one and tell them that they need to take care of themselves so that they can live healthy. You can get them help to make sure that they will not neglect themselves anymore. If a caregiver is neglecting them, you will need to take actions to make sure they are not going to be neglected anymore.