Beware: Self Neglect

Caregivers, Older Adults, and Vulnerable Folks

Photo by Julian Hochgesang on Unsplash

Before Dan moved to the memory care facility, I was living both of our lives. Dementia had taken over; he wandered and ran away - I had to find him.

He refused to let anyone touch his phone or computer, even though he could no longer use them safely. I watched him constantly, stealthily blocked specific phone contacts, and removed websites while he slept.

It wasn’t safe for him to drive the car - I made excuses for why I was driving or the keys didn’t work. There was no time or energy left to care for myself - which inevitably led to self-neglect.

Caregivers

The AARP website says

Devotion to caregiving is admirable, but the extent to which a caregiver may self-neglect is concerning. Many family caregivers find themselves in the same position—pivoting from one pressing task to the next without pausing to consider their own well-being. The tyranny of the urgent overwhelms any forethought and prudence. It is often a recipe for disaster.

It is not enough to tell family caregivers, as flight attendants tell airline passengers, “Put on your oxygen mask first.” Too many caregivers fail to practice self-care at all, let alone tend to their needs before those of the care receivers.

You can be so busy caring for your loved one, your job, and the pets that you forget or lack time for yourself.

Older Adults

But let’s say Dad has lived alone in an apartment since the death of his wife two years ago, an hour’s drive away. You talk with him regularly but haven’t visited for a month. However, his apartment and physical appearance are immaculate every time you do.

When you visit him this time, though, you smell a foul odor with no explainable source. The apartment is in disarray. There are dirty dishes on the counter and no food in the refrigerator. His clothes are disheveled. He is filthy and unshaven, but he says he’s fine.

You may be seeing a case of elder self-neglect. The U.S. Department of Health & Human Services defines it as

behavior of older people that threatens their health or safety and generally manifests itself by failing to provide adequate food, water, clothing, shelter, personal hygiene, medication, and safety precautions for themselves.

Warning signs may include the following:

• Poor personal hygiene.

• Unkempt appearance.

• Lack of essential food, clothing, or shelter.

• Malnutrition and dehydration.

• Living in unsanitary conditions and neglecting household maintenance.

• Hoarding.

• Keeping animals in inappropriate conditions.

Those conditions can be a red flag to check further - ask questions, talk to friends and neighbors, help him get back on track - assuming it is a short-term problem - and rule out medical conditions.

The article Self-Neglect in the Elderly: Knowing When and How to Intervene reminds caregivers to remember this.

There are various steps family members can take if they think their elderly loved one is not properly caring for themselves. The situation can be tricky because older adults capable of making their own decisions have the right to do so, even if others don’t agree.

If you decide to step in and help an older adult you think is self-neglecting, expect resistance. Many will accept your assistance, but some value their independence and will resent any interference in their lives.

Vulnerable Folks

Self-neglect can be an issue for people of all ages. It may lead to a less healthy lifestyle, with increased smoking, drug misuse, or lack of exercise.

Common characteristics can be:

• Living alone

• Being a woman (possibly because more women than men live alone)

• Being depressed and increasingly confused

• Being frail and elderly

• Having alcohol and drug problems

• Having a history of poor personal hygiene or living conditions

Tips for preventing self-neglect include the following.

• Avoid too much time alone.

• Stay in touch with others - participate in senior center activities, church functions, or other community groups.

• Meet the neighbors.

• Make sure others know of your health status.

• Schedule and attend medical and dental appointments.

Self-neglect can be an issue for caregivers, older adults, and family members—something to keep in mind.

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