RODALE NEWS, EMMAUS, PA—It's not uncommon to hear about elder neglect in nursing homes, but there's a more insidious threat to seniors—self-neglect—about which scientists know very little.
It's estimated that as many as 1.2 million adults over the age of 65 suffer from self-neglect, a condition defined by the National Centers on Elder Abuse (NCEA) as behaviors that threaten an individual's own health and safety—for instance, refusing or failing to take medications, or provide oneself with adequate food and water, clothing, shelter, and personal hygiene.
The exact causes of self-neglect are hard to pin down, but the condition can be brought on by depression, physical disabilities, medical problems, financial woes, and, based on the findings of a new study published in the journal Gerontology, a lack of social involvement, as well.
THE DETAILS: For this study, the researchers collected information on 9,056 adults over 65 who'd been recruited for a study in Chicago. Of those participants, 1,812 had been reported to the Chicago Department of Aging for elder self-neglect. Using demographics and social factors, they found that older adults more prone to self-neglect tended to be women and from lower-income levels, and they were more likely to suffer from a chronic medical condition such as heart disease, cancer, or diabetes. However, after adjusting for those factors, they found that those suffering from self-neglect also reported having lower levels of social engagements (external social activities like visiting a museum, attending a religious service, or taking part in some sort of group event) and lower-quality social networks (interactions with family and friends).
WHAT IT MEANS: A 2000 study from social service agencies found that elder self-neglect and abuse are serious but underrecognized public health problems. So, if an otherwise mentally competent older adult in your family seems to have just "given up," it may be time to look for signs that he or she is suffering from self-neglect. "Self-neglect manifests itself in many different ways," says Xin-Qi Dong, MD, associate professor of medicine at the Rush Institute for Healthy Aging in Chicago and lead author of the study. "We generally define it as a level of unmet needs." In addition to the symptoms above, he says, adults suffering from self-neglect may not keep house, or see to simple repairs like faulty wiring that could put them at risk. Or the neglect could be more severe, such as having an infected leg sore and refusing to go to the doctor about it, or leaving the stove on after cooking. Another study by Dr. Dong published in the August issue of the Journal of the American Medical Association found that self-neglect was associated with a higher rate of death within a year of the adult’s self-neglect being reported. "We have blood pressure problems, so we take medicine. We break our hips, we get that fixed," says Dr. Dong. "So we need to deal with self-neglect. Increasing self-neglect increases mortality, as well."
Self-neglect appears to be strongly associated with social well-being; here are some ways to keep an older adult in your family surrounded by a healthy social network:
• Pick up the phone. "A phone call is an important starting point," says Dr. Dong, not only because it boosts the recipient's mood, but shows the person that he or she has a high-quality social network. It also allows you to ask questions about whether they person is taking medications and eating properly, or inquire about household maintenance problems that you can help fix.
• Adopt an older adult in your neighborhood. People who are isolated may not be willing to ask for help, so take the initiative to visit an older adult in your neighborhood, particularly if that person is recently widowed or has lost a dear friend. "Losing members of one's social network significantly and profoundly affects their ability and willingness to care for themselves," says Dr. Dong. "If there's a certain event [like a death] that precipitates those losses, that very well may increase instances of self-neglect."
• Sign your parent or relative up for Meals on Wheels. He or she may not need the charity, but a daily or weekly visit from a Meals on Wheels volunteer reduces the isolation that a homebound adult may feel.
• Volunteer to drive your older adult to a senior center. "Encourage initiatives that will boost a willingness to take part in social activities," says Dr. Dong. If there's no senior center, volunteer to drive the older person to a religious service, or simply take him or her out for an afternoon of errand running.