Older Adult Self-Neglect

Older adult self-neglect, also known as elder self-neglect, happens when an elderly person can no longer meet their basic needs. An elderly person is 65 years of age or older.

Although older adult self-neglect doesn't involve a third-party perpetrator, it is still considered a form of elder abuse. In fact, most reported cases of older adult abuse involve self-neglect.

According to the Elder Justice Act, older adult self-neglect is the "inability, due to physical or mental impairment or diminished capacity, to perform essential self-care."

Moreover, the U.S Department of Health and Human Services defines self-neglect as “the behavior of an older adult that threatens their own health or safety and generally manifests itself by failure to provide themselves with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions."

Warning Signs and Symptoms

When a family member or loved one starts to exhibit signs of self-neglect, it is often time to consider hiring a caregiver or placing the older adult in an assisted living facility or nursing home. In general, typical signs and symptoms of older adult self-neglect fall under four categories:

• Environmental
• Physical
• Mental
• Financial

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)

• Inadequate or unclean clothing (soiled, improper dress for weather/conditions)

Physical Signs and Symptoms of Abuse

• Poor hygiene (dirty nails and skin, matted or lice-infested hair, presence of feces or urine)
• Bedsores or skin rashes
• Refusing medical care
• Untreated infections or unattended injuries
• Dehydration or malnutrition
• Weight loss

Mental Signs and Symptoms of Abuse

• Inadequate or inconsistent sleep
• Erratic behavior or mood swings
• Refusing medications
• Memory loss or forgetfulness
• Failure to remember to eat or drink

Financial Signs and Symptoms of Abuse

• Signs of unpaid bills and bounced checks

• Utility shut-offs and eviction notices
• Lack of food in the home
• Lack of needed medical aids (hearing aids, glasses, dentures)

Signs That Elder Abuse Is Contributing to Self-Neglect

If an older person is exhibiting self-neglecting behaviors, it could be a sign that they are experiencing another form of elder abuse, like sexual abuse, physical abuse, or financial exploitation. For example, if an older adult is being financially exploited, this could be the reason the older person is not buying basic necessities like food and medication.

How To Report Older Adult Self-Neglect

Older adult self-neglect often requires mental health and social service interventions. You may be a mandatory reporter of elder self-neglect, depending on your state's laws. Most healthcare providers are mandatory reporters.

APS offices provide social services, such as personal care and emergency shelter, to abused, neglected, or exploited older adults. They also work with vulnerable adults with disabilities or mental illness. To find the APS office near you, see the National Adult Protective Services Association, which provides a list of APS offices nationwide.

You can also report any suspicions of older adult self-neglect to local law enforcement, a long-term care ombudsman, or your state's toll-free elder abuse hotline.

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

If an older adult's self-neglect is affecting their finances or health care, they might 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 the mental capacity to make their own decisions.

This agent will then be able to make financial or healthcare decisions on the older adult's behalf. You can create a power of attorney with a simple standardized DIY form or with the help 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 older adult self-neglect, you might need a conservatorship or guardianship. This is especially the case when an older person:

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

A court appoints and supervises a conservator or guardian. 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.

More Resources To Help

For more information on general older adult abuse, see FindLaw's Elder Abuse Overview and Dealing With Elder Abuse. The National Center on Elder Abuse also has more information.

The Elder Care Locator is also a great resource if you are looking for a long-term care facility for your loved one or family member.

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