Q&A: What are common signs of elder self-neglect?

By Lisa Waxman

A: Elder self-neglect is the failure or refusal of an independent older adult to provide one or more of the necessities essential to their own physical and mental wellbeing.

What we often see is ordinary behavior that’s turned into self-neglect. They’ve been living a certain way for a very long time but as they age maybe their mobility decreases, their eyesight decreases, or maybe there’s more frailty, and a common situation can turn into self-neglect.

Lisa Waxman is a Community Social Worker at SCES

For example, we see throw rugs and scatter rugs in homes all the time.  For the most part they’re okay, but if you’re a fall risk or a little uneasy on your feet they can be a big problem. When an issue like this is identified, people are often reluctant– at least initially– to change any of their décor.

We also see self-neglect in some of the buildings in Somerville and Cambridge that have gone non-smoking. It’s hard to stop smoking, especially if you’ve been doing it for many years.  Some folks continue to smoke in their apartments or unauthorized areas of the building.  Unfortunately that puts them at risk for having legal issues with housing. That’s another form of self-neglect.

We also see self-neglect when people aren’t feeling well and don’t go to the doctor. They may also be resistant to follow up with treatments or take prescribed medication.  We actually see that quite a bit.

Sometimes people will have a stack of bills with which they feel overwhelmed.  They may decide they don’t want to pay a certain bill or that it can wait and that can put them at risk for losing utilities or housing.

These may sound like subtle things a lot of adults tend to do, but as we age these instances of self-neglect can be pretty consequential.

In those scenarios, we find that being very respectful is the best way proceed. You need to approach the situation from the other person’s point of view and work with them to acknowledge whatever the issue is, even if that takes some time. When you’re dealing with an adult, who is competent to make his/her own decisions, you need to respect his/her wishes, because that is how we all want to be treated.

 For more information, check out the Self-Neglect episode of Aging Well at the SCES Youtube Channel, or contact the SCES Aging Information Center at 617-628-2601 for free advice and guidance.