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Self–Neglect in the Elderly

By Daniel B. Kaplan, PhD, LICSW, Assistant Professor, Adelphi University School of Social Work
Barbara J. Berkman, DSW, PhD, Helen Rehr/Ruth Fitzdale Professor Emerita, Columbia University School of Social Work

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Patient Education

Self-neglect implies not caring for self. It can include ignoring personal hygiene, not paying bills, not maintaining the integrity or cleanliness of the home, not obtaining or preparing food (leading to undernutrition), not seeking medical care for potentially serious symptoms, not filling prescriptions or taking drugs, and skipping follow-up visits.

Risk factors for self-neglect include

  • Social isolation

  • Disorders that impair memory or judgment (eg, dementia)

  • The presence of multiple chronic disorders

  • Substance abuse

  • Severe depression

Differentiating between self-neglect and simply choosing to live in a way that others find undesirable can be difficult. Social workers are often in the best position to make this determination.

Adult Protective Services or the state unit on aging (whose numbers are available through the Eldercare Locator at 800-677-1116) can help by coordinating in-home safety assessments and helping the elderly obtain counseling services, emergency response systems, referrals to additional support services, and, if necessary, hospitalization.