Senior Self-Neglect and What Families Can Do About It

Skeptical senior man

Dad's not taking care of himself. Is it time to step in? Will he welcome your help?

Senior protection agencies are working hard to raise awareness of the crime of elder abuse. The public are encouraged to report suspicions of physical, emotional or financial abuse perpetrated against an older adult. Sadly, these crimes often are committed by a person an elder knows, even by a family member.

Neglect is another form of elder abuse. When a person who is in charge of the well-being of a senior fails to provide for their health and safety, that may be a criminal offense. But then, there is the complicated issue of self-neglect, when elders are unwilling or unable to keep themselves safe. The National Adult Protective Services Association (NAPSA) reports receiving more phone calls about self-neglect than any other form of elder abuse.

Physical or cognitive changes may make seniors less able to care for themselves and their home. The decline may be gradual. Family may notice there's a problem during visits, or maybe a helpful neighbor notifies them. Here are some common signs of self-neglect:

  • Unsanitary, cluttered conditions in the home.
  • Spoiled food in the kitchen.
  • Neglecting personal hygiene.
  • Dressing inappropriately for the climate.
  • Unpaid bills, mail piling up.
  • Social isolation and depression.
  • Weight loss, dehydration.
  • Trouble managing medications and health appointments.
  • Family pets not well-cared for.
  • Dangerous habits, such as leaving the stove on or the front door unlocked.

What can families do if they think senior loved ones aren't taking care of themselves?

Before doing anything, evaluate the situation carefully. Older adults who are capable of making decisions about their lives have the right to make them. They might not make lifestyle choices you would make — or even decisions they would have made before their lives were touched by illness or cognitive problems.

If your loved one has Alzheimer’s disease or other dementia, it’s time to talk to the doctor. The laws are different from state to state; it might be both necessary and possible for you to step in and serve as your loved one's guardian or in a similar capacity. But remember, even people with memory loss have the right to make their own decisions for as long as possible.

If you decide to step in, expect some resistance. It may be that your loved one will eagerly accept your assistance. But many seniors prize their independence highly and will resent even well-meaning "interference." It's so important to respect your loved one's sense of autonomy. Of late, experts have jokingly used the term "helicopter children" to describe adult children who try to control a senior parent's life. Just like the well-meaning "helicopter parents," these adult children may threaten their parent's sense of independence and inadvertently make the situation worse. Few seniors enjoy the role reversal when a child tries to parent them!

It's better to begin with a conversation. Express your concern, and offer to help. Saying "How can we figure out a way for you to be safer?" is better than "Mom, get your coat — we're going on a tour of assisted living communities." Tell your loved one how you feel: "I would sleep a lot better at night if I knew you weren't likely to trip over piles of newspapers."

Have a family meeting with your parent, siblings and anyone else involved. Call in professionals. Talk to your loved one's doctor. An aging life care professional (geriatric care manager) can help negotiate sensitive topics among parents and siblings. An elder law attorney can explain your legal and financial options, such as a guardianship or power of attorney.

With your loved one's participation, find out about resources in the community that can help. Moving to a supportive living environment, such as an assisted living community, might be the best choice. If your loved one wants to stay home, arrange for a home safety inspection and necessary adaptations. Locate senior transportation and nutrition programs, and learn about senior centers and other activities to keep your loved one socially connected.

The best solution could be to hire professional in-home care. Your loved one might balk at first, but most seniors quickly realize they prefer receiving assistance from a professional rather than from a family member. It preserves their dignity and they see that life is much better with an extra pair of hands.

Here are some of the services a professional caregiver can provide for your loved one:

Caregiver brushing a client's hair

Hygiene care. Caregivers help with bathing, dressing, grooming and incontinence care so your loved one will look and feel their best.

Housekeeping and laundry. The caregiver can keep the home tidy and clean, remove fall hazards, and be sure your loved one has a fresh supply of clean clothes.

Meal preparation and grocery shopping. The caregiver can prepare meals and snacks for your loved one and keep the fridge well-stocked with healthy food that also meets any special dietary requirements recommended by your loved one's healthcare provider.

Transportation. Seniors can quickly become isolated and depressed when they can't drive. The caregiver can take your loved one to doctor appointments, to the pharmacy, to their faith community, to visit friends … things they like to do that keep them socially engaged and active.

Memory care. If your loved one has Alzheimer's disease or a related condition but wants to stay home, they may be able to remain home longer with the assistance of a caregiver who is trained in dementia care.

Communicating with family. Whether you spend your days nearby at work, or you live at a distance from your loved one, it’s a big peace-of-mind plus to know the caregiver can alert you if anything's amiss, and provide regular updates about how your loved one is doing.

A final note … if the person isn't a relative

If you think a neighbor or other elder with whom you have contact is neglecting their own health and safety, contact their family if possible and share your concerns. NAPSA also says to contact your local Adult Protective Services (APS) agency if you think a senior is unsafe in their own home. Worried about being a busybody? NAPSA says, "What if you just have a 'feeling' about a situation but can't verify the details? APS workers are professional social workers trained to handle just such a situation. Based on your report, the agency will assess the situation and determine how best to respond."

For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.

Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned providers of in home care services.