Defining Elder Self-neglect
According to the American Society on Aging, social workers are reporting elder self-neglect among individuals age 65 and older as a significant and growing problem. The Elder Justice Act (2010) defines elder self-neglect as the “inability, due to physical or mental impairment or diminished capacity, to perform essential self-care.” Unfortunately, social workers indicate elder self-neglect is often unreported or goes unnoticed.
Why Self-neglect Occurs
Older adults are more likely to experience grief over the death of a spouse or friend. Grief puts them at risk of depression. Depression can also set in when older individuals are unable to easily get out of the house leading to increasingly limited social interactions. Grief and depression, in addition to dementia, which is common in older age, may lead to self-neglect. In 1965, the Older Americans Act (OAA) was passed by Congress aiming to provide community-based services such as food assistance, transportation support, and in-home care to the help the elderly age in place. A significant need for these services continues as the U.S. faces unprecedented growth in the over 65 population. This group is expected to make up 20% of the population by 2028.
The Red Flags of Self-neglect
Several red flags might indicate elder self-neglect is occurring. Potential indicators focus on the person’s inability to manage their home, health or hygiene needs including:
- Unkempt appearance and poor personal hygiene
- Lack of essential food, malnutrition and/or dehydration
- Over sedation or medication non-compliance
- Squalid or unsanitary living conditions
- Unable to manage basic household maintenance including paying bills
- Hoarding, including too many animals without appropriate space/care
- Non-compliance with health care services and missing appointments
If you see any of these signs, or have reasonable cause to suspect abuse, neglect, or exploitation of an adult, you should report the situation to the KY Adult Protection Branch of Community Based Services. The anonymous reporting form is now online at: https://prdweb.chfs.ky.gov/ReportAbuse/ (For emergencies call 911!)
Social workers can serve many roles in the prevention of elder self-neglect including educator, broker, and advocate.
Many people rely on family members and children to provide in-home care as they age. Often the family caregivers become stressed or burned out with the rigors of caring for the elderly person. Social workers may educate caregivers on coping strategies and self-care techniques to help manage stress. Mindfulness, breathing techniques, exercise, and getting enough sleep are all helpful tools for self-care.
Social workers also work to educate clients, their families and communities about self-neglect signs and prevention. We can provide prevention information at meetings, home visits, and in community groups.
Social workers broker important connections within the community. This role might work to increase support for the elderly person in order to reduce potential for self-neglect. Religious groups may provide transportation to services or meetings for the elderly. Bus-lines often have reduced or free transportation to and from grocery stores for those over 65. Volunteer groups provide pro-bono financial advice to help the elderly individual ensure bills are paid on time and help them set up a will and advanced directives for peace of mind.
Social workers should advocate at the local, state and national level for policies that support aging in place. Ensuring the community is aware of the needs of elderly individuals and encouraging increased service availability is essential.
Social Workers are an important link between the elderly and local services that can support aging in place and prevent self-neglect from happening. As the aging population increases over the next decade social workers will be essential in prevention of self-neglect among the elderly.
By Erin Stevenson, PhD, MSW, visiting professor, EKU Department of Anthropology, Sociology and Social Work
Boothroyd, K. (2019). Elder self-neglect is a growing and largely hidden problem. American Society on Aging. Retrieved from https://www.asaging.org/blog/elder-self-neglect-growing-and-largely-hidden-problem
Mather, M., Jacobsen, L.A., & Pollard, K.M. (2015). Aging in the United States. Population Reference Bureau Bulletin,70(2), 1-21. Retrieved from https://www.prb.org/wp-content/uploads/2016/01/aging-us-population-bulletin-1.pdf
Population Reference Bureau. (2013). Helping Americans age in place: Research highlights in the demography and economics of aging. Aging Centers, (13), 1-9. Retrieved from https://www.prb.org/wp-content/uploads/2013/05/research-highlights-aging-2013.pdf
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