Self Neglect

Self-neglect is a general term used to describe a vulnerable adult living in a way that puts his or her health, safety, or well-being at risk.

Self-neglect by vulnerable adults is a serious problem. It can be difficult to know when or if you should get involved. Law enforcement and social service agencies cannot be everywhere. Your help is needed.

Learn more about:

• What is self-neglect?
• Common characteristics of people who neglect themselves.
• Signs to look for.
• What families, friends, neighbors, and service providers can do to help.
• Tips for preventing self neglect as you age.
• What can be done by Adult Protective Services?

What is self-neglect?

Vulnerable adults who neglect themselves are unwilling or unable to do needed self-care. This can include such things as:

• Not eating enough food to the point of malnourishment.
• Wearing clothes that are filthy, torn, or not suited for the weather.
• Living in filthy, unsanitary, or hazardous conditions.
• Not getting needed medical care.

Common characteristics of people who neglect themselves.

There are some common characteristics of a adults who neglect themselves. He or she is more likely to:

• Live alone.
• Be women (possibility because more women than men live alone).
• Be depressed and/or increasingly confused.
• Be frail and elderly.
• Have alcohol and drug problems.
• Have a history of poor personal hygiene or living conditions.

Signs to look for

The Home

• Not enough food, water, heat.
• Filth or bad odors, hazardous, unsafe, or unclean living conditions.
• Major repairs are needed and not done.
• Human or animal feces.
• Hoarding: nothing is thrown away, stacks of papers, magazines.
• Animal or insect infestation.

The Person

• Poor personal hygiene (dirty hair, nails, skin).
• Smells of feces or urine.
• Unclothed, or improperly dressed for weather.
• Skin rashes or bed sores (pressure ulcers).
• Dehydrated, malnourished or weight loss..
• Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or a commode.
• Increased dementia, confusion, disorientation.
• Unexpected or unexplained worsening of health or living conditions.
• Spending too much time alone or isolated from former activities.
• Lack of interest or concern about life.
• Untreated medical conditions.
• Self-destructive behaviors or significant behavior changes.
• Hallucinations, delusions.
• Misusing drugs or alcohol.

What families, friends, neighbors, and service providers can do to help.

Social support by family, members of the community, and service providers is very important in helping vulnerable adults remain safely in the community.

Family and friends:

• Learn what signs and symptoms to look for.
• Help the adult to reduce isolation as much as possible. Community services such as friendly visiting, regular telephone calls, and volunteer driving may help reduce the isolation of a vulnerable adult.
• Stay in contact.
• Talk to the person. Sometime just allowing someone to express themselves opens the door to finding solutions. Help the person review options and make his or her own choices.
• Help the person accept help from others.
• Help the person get any services he or she may need.
• Get help from Adult Protective Services if you are concerned an adult may be self-neglecting.
• If a vulnerable adult chooses to be neglectful, you must respect his or her choice in any attempt to help.

• Stay alert to any changes that might indicate a problem with an aging neighbor. Are newspapers piling up on the porch? Are treasured animals loosing weight or uncared for? Is there a significant, negative change in the person’s routine?

• If you become concerned, go over and knock on the door. Many people do not make this step because they don’t want to intrude. Law enforcement and social service agencies cannot be everywhere. Your help is needed and may be easier for the person to accept than help from an agency or law enforcement.
• Listen and offer your support.
• Get help from Adult Protective Services if you are concerned an adult may be self-neglecting.
• Call 911 if the person needs immediate medical attention or is in danger of immediate harm.

Mail carriers, utility workers, other service providers

• Stay alert to any changes that might indicate a problem with an aging customer. Is mail or newspapers piling up? Is there a significant, negative change in his or her behavior that concerns you? Stay alert for signs a person may be in trouble.
• If you become concerned, knock on the door. Law enforcement and social service agencies cannot be everywhere. Your help is needed.
• If the person does not answer the door and you are concerned for their safety, call 911 and ask for a welfare check.
• Get help from Adult Protective Services if you are concerned an adult may be self-neglecting.

Police and other first responders

• Report your concerns immediately to Adult Protective Services. Learn more about being a mandatory reporter.

Tips for preventing self neglect as you age.

Isolation is common among all types of self-neglect. Avoiding spending too much time alone is very important.

• Stay in touch with others. Become involved in senior center activities, church functions, or other groups in your community.
• Get to know your neighbors.
• Make sure another person or two is aware of your health status on a regular basis.
• Schedule and go to regular medical and dental appointments.

What can be done by Adult Protective Services (APS)?

Learn More

APS can be part of a community’s involvement in aiding a self-neglecting vulnerable adult. With the person’s consent, APS will do everything possible to ensure his or her safety and well-being once the case has been reported and investigated.

Some adults may refuse help. This presents a dilemma for anyone trying to help a self-neglecting adult. How do you balance the person’s right to this independence and help make sure he or she is safe and well?

There is no easy answer and each case must be treated individually. Help by family, friends, services providers, APS, or health care interventions can be offered but the person has to accept that help.

APS can’t remove a person from his or her home against their will or force them to accept help. Because of this, APS staff and law enforcement are sometimes stopped from providing help to people who need it.

APS can intervene without the consent of the vulnerable adult only if all other avenues have been exhausted, the person is found incompetent by the courts, and a court order has been granted to appoint a legal guardian to make decisions on his or her behalf.

A person who refuses help may eventually accept it. It is important for everyone to stay involved and support the vulnerable adult as much as he or she will allow.

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