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Eleanor is being abused.
She lays in her bed most of the day and has little contact with others. Her house is cramped, unclean and poorly ventilated. Her meals are sporadic and lack significant nutritional content, plus much of the food she has in the house is spoiled. She gets no help with bathing, takes infrequent baths, has an odor and is developing sores. She is never taken to the doctor. Clearly, Eleanor is being neglected, but who is neglecting her?
Eleanor is the victim of self-neglect. Her children and friends dismiss her condition. Her children say that "Mom has never taken really good care of herself." Her friends feel that she could take better care of herself, but she just doesn't want to. "She is an adult; she can do what she wants," they reason. Ultimately, both groups decide not to get involved because they believe that Eleanor is proud, stubborn and wouldn't want them "butting in." Besides, "if she really needed help, she'd ask for it."
Eleanor is a fictional example, but elder self-neglect is a very real problem. According to the AARP Public Policy Institute, self-neglect is the most common form of elder abuse, representing 40 to 50 percent of cases reported to states' adult protective services agencies. And, like other forms of elder abuse, it is feared that many more cases go unreported.
Self-neglect occurs when an individual fails to attend to her own basic needs. These can include personal hygiene, appropriate clothing, feeding or tending appropriately to any medical conditions she has. The contributing factors for self-neglect are as varied and unique as the people who fall victim to it. They include lifelong patterns of self-neglecting behavior, dementia, illness, malnutrition, overmedication, poverty, substance abuse, depression and isolation.
Self-neglect can be passive or active. In passive neglect, the individual may not know her needs are not being met. She has no desire to harm herself, but lacks the capacity or the resources to properly care for herself. In active neglect, the individual chooses to ignore her own needs. This may be due to a behavioral health issue such as depression, or she could be sacrificing her self care to care for someone else.
There are several things you can do to help a loved one or friend who may be neglecting herself:
If you feel the self-neglect has the potential to cause real harm to the individual, report it to your local adult protective services agency, usually housed within your county department of job and family services. If the individual is in immediate danger of physical harm stemming from self-neglect or some other type of abuse, call local law enforcement right away.
Don't ignore self-neglect. Help the Eleanor in your life get the care she needs by reducing her isolation and helping her access supports and resources.