Could Self‐Neglect in Older Adults Be a Geriatric Syndrome?

Abstract

Self-neglect in older adults is a complex phenomenon characterized by inattention to health and hygiene, typically stemming from an inability or unwillingness to access potentially remediating services. Some aspects of self-neglect clinically resemble geriatric syndromes (e.g., falling, incontinence). The literature on self-neglect was comprehensively reviewed and its quality evaluated in the context of considering its candidacy for a geriatric syndrome. MEDLINE (1966-2004) was searched using self-neglect as a keyword. Using a "snowball" sampling strategy, associated terms (e.g., Diogenes' syndrome) were combined, selecting relevant papers and frequently cited references, assessing each one using specific criteria. Its candidacy for consideration for a geriatric syndrome was assessed based on the quality of data in four domains: multifactorial etiology, shared risk factors with other geriatric syndromes, association with functional decline, and association with increased mortality. The 54 articles reviewed included 24 case series, 13 theoretical articles, 11 observational studies, and six reviews; these were of highly variable methodological quality. The strongest evidence that self-neglect may be a geriatric syndrome includes its often multifactorial etiology, its clear independent association with increased mortality, and the fact that two other geriatric syndromes (cognitive impairment and depression) are risk factors for self-neglect. Self-neglect in older adults is a prevalent problem that appears to have at least some features of a geriatric syndrome. Insofar as the concept of geriatric syndrome has been a useful clinical and research paradigm to create interventions for vulnerable older adults, and no such strategies are available for this vexing and understudied clinical problem, future research is warranted in this area.

Determınatıon Of The Causes That Force The Elders To Choose Nursıng Home Lıves

“…Kendi kendini ihmal eden kişiler kronik hastalıklar ve fiziksel yetersizliklerle karşı karşıya olmaktadır-lar. Bu fiziksel yetersizlikler, yürüyüşte bozukluk, zayıf fonksiyonel durum, algısal bozukluk (işitme ve görme) ve düşmeler olarak belirtilmektedir (28,29) .…”

Home Alone With Dementia

“…Some self-neglect is mild and poses little danger, but self-neglecting behaviors in vulnerable elders can sometimes be severe and bring extreme health and safety risks (Dyer, Pickens, & Burnett, 2007). Self-neglect is a complex phenomenon that is characterized by lack of attention to health and hygiene, often because the person is unable or unwilling to access support services (Pavlou & Lachs, 2006). The manifestations occur along a continuum and the negative impact on health is related to behaviors such as poor medication adherence, failing to keep medical appointments, ignoring serious medical issues, allowing food to spoil, and poor personal hygiene (Dyer et al, 2007).…”

Is Self neglect associated with the Emotional and financial abuse in community-dueling?

“…On the other side, some experts (Band-Winterstein et al, 2012) believe that self-neglect should be considered as a life course story instead of geriatric syndrome (Pavlou and Lachs, 2006). However, opponents emphasize on diagnosis syndrome of self neglect that associated to dementia, neuropsychological and social risk factors such as living alone (Tierney et al, 2007;Dick, 2006).…”

“…Based on ESN definition by this center, self neglect is considered as behavior of elderly that threatens their own health and safety. Most existing information about self neglect is related to reports from social service agencies (Pavlou and Lachs, 2006) that show the prevalence of ESN is increasing. Based on National Center on Elder Abuse (2006), the categories of abuse in older persons aged 60:  Self-neglect was the most common category of investigated reports (49,809 reports or 26.7%), followed by caregiver neglect (23.7%), and financial exploitation (20.8%) (195 States).…”