New Survey Finds Self-Neglect of Elderly is a Growing often Hidden Problem, More Common than Physical, Sexual or Emotional Abuse; Elder Care Experts Report Tragic Cases

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Self-neglect among the elderly is a growing problem that commonly goes unreported, according a new survey of elder care experts released today. Elderly couple surviving on Pepsi and granola bars among tragic cases revealed in survey results.

“Elderly self-neglect is a growing and largely hidden national problem,” said Emily Saltz, NAPGCM President. “Families and friends need to know the warning signs and be on the look out to safeguard their elderly loved ones.”

Self-neglect among the elderly is a growing problem that commonly goes unreported, according a new survey of elder care experts issued today by the National Association of Professional Geriatric Care Managers (NAPGCM). The survey finds that self-neglect among seniors is the most common form of non-financial elderly abuse/neglect encountered by care managers, far outpacing encounters with physical or sexual abuse or neglect by others.    

The National Adult Protective Services Association (NAPSA) defines self-neglect as: “an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care….” They make clear that life-style choices or living arrangements alone do not prove self-neglect. According to NAPSA, in many communities self-neglect accounts for more than 50% of adult protective service referrals and caseloads.

“Elderly self-neglect is a growing and largely hidden national problem,” said Emily Saltz, NAPGCM President.    “Families and friends need to know the warning signs and be on the look out to safeguard their elderly loved ones.”

Key Findings of the NAPGCM Survey (298 geriatric care managers surveyed from 9/12 to 9/16/2014):

  •     92 percent of care managers said that elderly self-neglect was a significant problem in their community, with 52 percent saying it is significant and growing problem.
  •     94 percent of care managers agreed that elderly self-neglect is a largely hidden problem with cases frequently or mostly going unreported.
  •     76 percent of the care managers surveyed reported that elderly self-neglect is the most common non-financial form of elder abuse/neglect that they encounter in their practices. Another form of neglect – that by family or others was the 2nd most commonly reported form (16 percent), followed by emotional/psychological abuse (8 percent) and physical and sexual abuse (1 percent).
  •     The 6 warning signs of self-neglect most often cited by care managers are:    

o    Signs of poor personal hygiene/not bathing or taking care of hair and nails (92 %)
o    Poor medication management or refusing to take medications (89%)
o    Signs of dehydration, malnutrition or other unattended health conditions (75%)
o    Unsanitary of very unclean living quarters (72%)
o    Signs of unpaid bills, bounced checks or utility shut-offs (64%)
o    Lack of adequate food in house or signs of weight loss (63%)

Geriatric Care Managers responding to the NAPGCM poll shared over 150 cases of self-neglect encountered in their practices. Attached are a sample of cases. Typical of the tragic stories reported include:

“…Senior was living alone and unwilling to accept help because she said "nothing is wrong." She had weight loss of 40 pounds, mail piled up, and bills unpaid despite saying she was "going thru my papers.” There was wet underwear from urine hung up to dry (not washed out). She was forgetting to take her pills. BUT, THE CAT IS ALWAYS FED!”

“A husband and wife both had dementia. The husband had always been in charge, and at one time had been quite capable. When I met them, his dementia was significant enough that he could no longer effectively and safely run the household and neither one of them realized this. Huge hoarding issue with papers, magazines, books, computers...beautiful house was FULL of stuff, so much that it was challenging to walk through. Husband had frequent falls. Neither was cooking. They were surviving on granola bars and Pepsi.”

“78 year-old man with large oozing sores on both shins refused to go to wound care specialist and insisted his podiatrist was handling the problem. We later learned he never went to the podiatrist, instead would sit in his car for approximately the length of time the appointment would have taken, then drive home. He refused to allow son or care manager to accompany him or meet him at his physician's office. His legs were usually wrapped in ACE bandages which did nothing to stop the oozing. He later died in a nursing home after refusing wound care.”

Two significant population trends point to further increases in elderly self-neglect. A government report found that a record 11.3 million older Americans -- fully half of women age 75 or older -- now live by themselves.    And according to the Alzheimer’s Association, the number of Americans with Alzheimer's disease and other dementias will nearly triple, from 5 million to as many as 16 million by 2050.

What should be done? Where and how to report? The National Center on Elder Abuse provides a listing of resources in every state for reporting and responding to cases of elderly self-neglect.

About NAPGCM
The National Association of Professional Geriatric Care Managers (NAPGCM) was formed in 1985 to advance dignified care for older adults and their families. Geriatric Care Managers are professionals who have extensive training and experience working with older people, people with disabilities and families who need assistance with caregiving issues. They assist older adults who wish to remain in their homes, or can help families in the search for a suitable nursing home placement or extended care if the need occurs. To find a listing of professional geriatric care managers in your community go to the NAPGCM website and click on “Find a Care Manager”.

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Noel Gerson
NAPGCM
+1 (301) 320-2920
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Noel Gerson