Elder self-neglect occurs when an elderly person is no longer able to meet his or her basic daily needs. According to the Elder Justice Act, which was enacted in 2010, elder self-neglect is defined as the "inability, due to physical or mental impairment or diminished capacity, to perform essential self-care." This would include an elder's inability to maintain his or her basic daily necessities such as food, clothing, shelter, or medical care, or to manage his or her financial affairs.
Although elder self-neglect doesn’t involve a third-party perpetrator, it’s still considered a form of elder abuse that raises serious health and safety concerns. In fact, most reported cases of elder abuse involve elder self-neglect. The Public Policy Institute of the AARP estimates that between 40% to 50% of cases reported to Adult Protective Services involve self-neglect. In some states, the number is higher. In Virginia, for example, 55% of substantiated reports to Adult Protective Services in 2013 involved self-neglect.
Signs and Symptoms
Typical signs and symptoms of elder self-neglect include:
- Unsanitary living conditions (foul odors, animal or insect infestations, piles of trash)
- Unsafe living conditions (inadequate plumbing, heating/air, ventilation, home in disrepair)
- Lack of food in the residence
- Inadequate or unclean clothing (soiled, improper dress for weather/conditions)
- Lack of needed medical aids (hearing aids, glasses, dentures)
- Unpaid bills
- Poor personal hygiene (dirty nails and skin, matted or lice-infested hair, presence of feces or urine)
- Bedsores or skin rashes
- Untreated infections or unattended injuries
- Dehydration or malnutrition
- Weight loss
- Inadequate or inconsistent sleep
How to Respond to Elder Self-Neglect
If you suspect a case of elder self-neglect, contact your local Adult Protective Services office for further guidance. APS offices provide social services to abused, neglected, or exploited elders or adults with certain disabilities. To find the APS office near you, see the National Adult Protective Services Association, which provides a list of APS offices nationwide.
Additionally, if an elder's self-neglect is affecting their finances or health care and if the elder still has mental capacity, they may be able to sign a power of attorney naming a trusted individual (or a professional fiduciary) as the elder’s agent. This agent will then be able to make financial or health care decisions on the elder’s behalf. A power of attorney can be prepared using simple standardized DIY forms or with the assistance of an estate planning attorney.
For more information on Powers of Attorney, see FindLaw's "Help a Loved One Make a Power of Attorney."
In some instances of elder self-neglect, a conservatorship or guardianship may be required. This is especially the case where an elder is suffering from diminished mental capacity or is resistant to outside intervention and doesn’t want to sign a power of attorney. A conservator or guardian is appointed and supervised by the court and is normally granted the authority to manage the personal, financial, and health care decisions of an adult who is not able to do so on their own.
For more information about conservatorships and guardianships, see FindLaw's "What is a Conservatorship? Five Basic Questions."
For additional information on elder abuse generally, see FindLaw's "Elder Abuse Overview" and "Dealing With Elder Abuse." Additional information on elder abuse can be obtained from the National Center on Elder Abuse.
If you aren't sure where to turn, start with talking to an Elder Law attorney about the situation.