Sadly self-neglect is becoming more prevalent in todays world. However, what truly qualifies as self neglect can be unclear for many. Self neglect describes an individual who is living in a dysfunctional manner that puts them at risk and negatively impacts their physical and mental health, safety, or overall well-being. Our most vulnerable populations such older adults and those with mental health issues are most at risk for self neglect.
What are some red flags for self neglect:
Not routinely bathing and appearing dirty or having an odor
Wearing dirty, torn, badly worn clothing
Not dressing for weather conditions (no coat, over too many layers, etc)
Not wearing shoes or footwear when appropriate
Not wanting to purchase food, not seeing food in home
Not eating regularly or showing / appearing malnourished.
Living in cluttered, dirty, disorganized, or hazardous conditions.
Home showing disrepair or lack of maintenance to routine items
Home hot in summer or excessively cold in winter
Living in a home with odors, pet droppings , dirty dishes or old food left out or piled
Exhibiting hoarding behaviors, saving everything even unsanitary items
Bug or rodent issues noted.
Refusing necessary or advised medical care and treatment.
Not seeking critical medical attention when needed.
Not taking medications as prescribed or following orders for PT, follow up appointments, etc.
Skin issues or signs of lice or scabies seen. (rashes, sores)
Withdrawing socially, isolating self, dismissing others, and living alone
The lack of essential items such as toilet paper, soap, tooth paste, hearing aids, glasses, canes, dentures, a walker.
Wanting to be left alone and getting angry when visited or others in home
Attached to personal items in home and defensive about any change or disposition of clutter, etc.
Teeth with discoloration, decay, or bad breath
Showing signs of sadness, flat affect, or depression.
Confusion, agitation, paranoia, or anger issues
Any patterns of constant self destructive behavior
Showing signs of an alcohol and drug (even prescription drug) dependency.
So what can be done to help?
Everything should be done to support and develop trust with the individual experiencing self neglect. Sadly when people behave this way many times others withdraw. Mental health issues are often times dismissed and not addressed in a serious manner. Self neglect is serious and should not be ignored.
If interventions attempted to assist and adjust the situation in a functional way are not successful individuals should reach out to adult protective services promptly for guidance. All health care professionals have a professional obligation to report self neglect to adult protective services. However, social service agencies cannot always intervene or make an immediate impact as sadly unless a person legally lacks capacity they are permitted to make poor choices and cannot be forced to access proper care, etc. Seeking guidance and support from a mental health professional or special needs attorney can be essential in finding a true long term solution to stop the cycle of self neglect.