Older Adult Self-Neglect

Elder self-neglect occurs when an older adult can no longer meet their basic daily needs. According to the Elder Justice Act, enacted in 2010, older adult 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 older person's inability to maintain their basic daily necessities such as food, clothing, shelter, medical care, or to manage their financial affairs.

Although older adult self-neglect doesn’t involve a third-party perpetrator, it’s still considered a form of elder abuse. Any form of abuse raises serious health and safety concerns.

In fact, most reported cases of older adult abuse involve elder self-neglect. It is estimated that between 40% to 50% of cases reported to Adult Protective Services involve self-neglect. In some states, the number is higher.

Signs and Symptoms

Typical signs and symptoms of elder self-neglect include three areas:

• Environmental
• Physical
• Behavioral

Environmental Signs and Symptoms of Abuse

• 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

Physical/Behavioral Signs and Symptoms of Abuse

• 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 Older Adult Self-Neglect: APS

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 older adults. They also work with 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.

Responding to Older Adult Self-Neglect: Power of Attorney (POA)

Additionally, if an older adult's self-neglect is affecting their finances or health care, they may be able to sign a power of attorney. This names a trusted individual (or a professional fiduciary) as the elder’s agent. A POA is only possible if the older person still has mental capacity. 

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."

Responding to Older Adult Self-Neglect: Conservatorship or Guardianship

In some instances of elder self-neglect, a conservatorship or guardianship may be required. This is especially the case where an older person:

• Suffers from diminished mental capacity
• Is resistant to outside intervention
• Doesn’t want to sign a power of attorney

A conservator or guardian is appointed and supervised by the court. They are normally granted the authority to manage the personal, financial, and health care decisions of an adult who cannot do so on their own.

For more information about conservatorships and guardianships, see FindLaw's "What is a Conservatorship? Five Basic Questions."

Additional Resources To Help

For additional information on general older adult abuse, see FindLaw's "Elder Abuse Overview" and "Dealing With Elder Abuse." Additional information on older adult abuse can be obtained from the National Center on Elder Abuse.

If you aren't sure where to turn, start by talking to an Elder Law attorney about the situation.