How to recognize elder self-neglect and provide help

Purple ribbons are a symbol of elder abuse awareness.


Change is one of the few constants in life. But sometimes things change for the worse, when a friend or loved one seems to be neglecting their own needs and putting their well-being at-risk.

It’s called self-neglect, and assistance is often available if you know the warning signs.

In Massachusetts, self-neglect is defined as older adults or adults with disabilities whose health, safety, or well-being is at-risk because they are not meeting their own essential physical, psychological, or social needs.

Common signs of self-neglect include insufficient food, clothing, shelter, health care, financial concerns, or unsafe housing. Issues like these are not always easy to spot from the outside, but these are common warning signs:

  • Weight loss, poor hygiene, bedsores, inappropriate clothing
  • Mismanagement of medications or frequent hospitalizations
  • Home safety issues, hoarding behavior, lack of proper utilities, unsafe structures
  • Eviction or foreclosure
  • Wandering
  • Unsafe behavior related to smoking, stove usage, or driving
  • Unpaid bills or compulsive spending

Self-neglect is considered a form of elder abuse, and it is routinely the most common form of abuse that gets reported locally. Fortunately, there are ways to help.

What can I do to help?

  • If you are concerned about someone you are close with, try talking to them to learn more about what is going on in their life. Listening without judgment and showing interest are good ways to start the conversation.
  • If you think someone is in immediate danger, call 911 or the Police.
  • If there is no immediate danger, but you are concerned about abuse or neglect, call the Mass Elder Abuse Hotline at 1-800-922-2275.

The confidential hotline is a gateway to your local Adult Protective Services program, which can help evaluate the situation and work with the older adult to help reduce risk factors. Adult Protective Services is a social work-based program that alleviates and reduces risk for people age 60 and over. Protective Service Workers work with elders, their family and community agencies to provide medical, mental health, legal and social services.

Elder Abuse Awareness Month

June is Elder Abuse Awareness Month. Each June Somerville-Cambridge Elder Services (SCES) and the Cambridge Council on Aging (COA) work together to distribute information about elder abuse and local resources. We also distribute purple ribbons, which symbolize elder abuse awareness. Join us in spreading awareness by sharing our information graphics on Facebook and Instagram and using the hashtag #KnowElderAbuse.

Did you know that at least 1 in 10 older adults has experienced some form of abuse, but only one in 14 cases are reported? Elder abuse is an action, or failure to act, that creates harm or significant risk of harm for someone age 60 or over. It can manifest as physical, emotional or sexual abuse as well as neglect or exploitation. Each case is unique, but these are common warning signs:

  • Unexplained financial loss
  • Unexplained bruises or injuries
  • Isolation
  • Verbal abuse
  • Threats
  • Changes in mood or behavior
  • Rapid decline in health or mental status
  • Sudden confusion
  • Unexplained weight loss
  • Neglecting Care Needs
  • Hesitation to speak openly

Elder abuse is a silent epidemic that impacts older adults across all income levels, cultures, genders, and races. By knowing the signs of abuse and how to help, we can all do our part to help mitigate this silent epidemic.

Susan Pacheco is director of the Cambridge Council on Aging, which works to promote the health and independence of local older adults by providing meaningful social and recreational options. Norah Al-Wetaid is Director of  Adult Protective Services at Somerville-Cambridge Elder Services, a non-profit dedicated to supporting the independence and well-being of older adults, and people with disabilities.