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Neglect and Self-Neglect of Older Adults

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Handbook of Interpersonal Violence and Abuse Across the Lifespan

Abstract

Elder neglect is the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder. Self-neglect is the failure to provide for one’s self. Both are among the most commonly reported cases to Adult Protectives Services which is the agency in every state in the USA charged with the investigations of complaints about the well-being and health as well as the protection of vulnerable adults.

These two phenomena arise when the older person experiences a decline in either mental or physical function. This decline is often caused by diseases such as dementia, depression, alcohol abuse, frailty, or late life psychiatric and geriatric syndromes. These illnesses or normal aging often lead to executive dysfunction: the inability to plan, sequence, and carry out the tasks of daily living. Those with impaired cognition can lose decision-making capacity as well as the capacity for self-care and self-protection. When caregiver support is either substandard or absent, the result is serious morbidity and mortality. (See “Berman Intersectionality of Elder Abuse and Mental Health Issues”.

Social justice for these vulnerable seniors can be achieved through various channels. These include the training of health care providers, universal screening, the more widespread use of multidisciplinary intervention teams, and community senior centers. Future strategies include the establishment of forensic centers, more in-depth research, as well as the use of information technology to increase access and efficiency for afflicted older adults.

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References

  • Abrams, R., Lachs, M., McAvay, G., Keohane, D., & Bruce, M. (2002). Predictors of self-neglect in community-dwelling elders. American Journal of Psychiatry, 159(10), 1724–1730.

    Google Scholar 

  • Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder Mistreatment Study. American Journal of Public Health, 100(2), 292–297.

    Google Scholar 

  • Albert, S., & Freedman, V. A. (2009). Public health and aging: Maximizing function and Well-being (second). Springer. Retrieved from https://market.android.com/details?id=book-6FllmNfNAowC.

  • Amstadter, A. B., Zajac, K., Strachan, M., Hernandez, M. A., Kilpatrick, D. G., et al. (2011). Prevalence and correlates of elder mistreatment in South Carolina: The South Carolina elder mistreatment study. Journal of Interpersonal Violence, 26(15), 2947–2972.

    Google Scholar 

  • Blenkner, M., Bloom, M., & Nielsen, M. (1971). A research and demonstration project of protective Services. Social Casework, 52(8), 483–499.

    Google Scholar 

  • Bond, M. C., & Butler, K. H. (2013). Elder abuse and neglect: Definitions, epidemiology, and approaches to emergency department screening. Clinics in Geriatric Medicine, 29(1), 257–273.

    Google Scholar 

  • Bonnie, R., & Wallace, R. (Eds.). (2003). Elder mistreatment: Abuse, neglect, and exploitation in an aging America. Washington, DC: National Academy Press.

    Google Scholar 

  • Burgess, A. W., Ramsey-Klawsnik, H., & Gregorian, S. B. (2008). Comparing routes of reporting in elder sexual abuse cases. Journal of Elder Abuse & Neglect, 20(4), 336–352.

    Google Scholar 

  • Burnes, D., Pillemer, K., Caccamise, P. L., Mason, A., Henderson, C. R., Berman, J., et al. (2015). Prevalence of and risk factors for elder abuse and neglect in the community: A population-based study. Journal of the American Geriatrics Society, 63(9), 1906–1912.

    Google Scholar 

  • Burnett, J., Regev, T., Pickens, S., Prati, L. L., Aung, K., Moore, J., & Dyer, C. B. (2007). Social networks: A profile of the elderly who self-neglect. Journal of Elder Abuse & Neglect, 18(4), 35–49.

    Google Scholar 

  • Burnett, J., Dyer, C., Halphen, J., Achenbaum, W., Green, C., Booker, J., & Diamond, P. (2014). Four subtypes of self-neglect in older adults: Results of a latent class analysis. Journal of the American Geriatrics Society, 62(6), 1127–1132.

    Google Scholar 

  • Cannell, M. B., Jetelina, K. K., Zavadsky, M., & Gonzalez, J. M. R. (2016). Towards the development of a screening tool to enhance the detection of elder abuse and neglect by emergency medical technicians (EMTs): A qualitative study. BMC Emergency Medicine, 16(1), 19.

    Google Scholar 

  • Clark, A., Mankikar, G., & Gray, I. (1975). Diogenes syndrome: A clinical study of gross neglect in old age. The Lancet, 305(7903), 366–368.

    Google Scholar 

  • Definitions | Elder Abuse. (2018). Retrieved from https://www.cdc.gov/violenceprevention/elderabuse/definitions.html

  • Dong, X. (2014). Self-neglect in an elderly community-dwelling U.S. Chinese population: Findings from the population study of Chinese elderly in Chicago study. Journal of the American Geriatrics Society, 62(12), 2391–2397.

    Google Scholar 

  • Dong, X., & Simon, M. A. (2013). Association between elder self-neglect and hospice utilization in a community population. Archives of Gerontology and Geriatrics, 56(1), 192–198.

    Google Scholar 

  • Dong, X., & Simon, M. A. (2015). Elder self-neglect is associated with an increased rate of 30-day hospital readmission: Findings from the Chicago health and aging project. Gerontology, 61(1), 41–50.

    Google Scholar 

  • Dong, X., Simon, M., Mendes de Leon, C., Fulmer, T., Beck, T., et al. (2009). Elder self-neglect and abuse and mortality risk in a community-dwelling population. Journal of the American Medical Association, 302(5), 517–526.

    Google Scholar 

  • Dong, X. Q., Simon, M., & Evans, D. (2010a). Cross-sectional study of the characteristics of reported elder self-neglect in a community-dwelling population: Findings from a population-based cohort. Gerontology, 56(3), 325–334.

    Google Scholar 

  • Dong, X., Simon, M. A., Wilson, R. S., Mendes de Leon, C. F., Rajan, K. B., & Evans, D. A. (2010b). Decline in cognitive function and risk of elder self-neglect: Finding from the Chicago health aging project. Journal of the American Geriatrics Society, 58(12), 2292–2299.

    Google Scholar 

  • Dong, X., Simon, M. A., Fulmer, T., Mendes de Leon, C. F., Hebert, L. E., et al. (2011). A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 66(6), 695–704.

    Google Scholar 

  • Dong, X., Simon, M. A., & Evans, D. (2012a). Prospective study of the elder self-neglect and ED use in a community population. The American Journal of Emergency Medicine, 30(4), 553–561.

    Google Scholar 

  • Dong, X., Simon, M. A., & Evans, D. (2012b). Elder self-neglect and hospitalization: Findings from the Chicago health and aging project. Journal of the American Geriatrics Society, 60(2), 202–209.

    Google Scholar 

  • Dong, X., Simon, M. A., & Evans, D. A. (2012c). Prevalence of self-neglect across gender, race, and socioeconomic status: Findings from the Chicago health and aging project. Gerontology, 58, 258–268.

    Google Scholar 

  • Dyer, C. B., Pavlik, V. N., Murphy, K. P., & Hyman, D. J. (2000). The high prevalence of depression and dementia in elder neglect. Journal of the American Geriatric Society, 48(2), 205–208.

    Google Scholar 

  • Dyer, C., Toronjo, C., Cunningham, M., Festa, N., Pavlik, V., Hyman, D., et al. (2006). The key elements of elder neglect: A survey of adult protective service workers. Journal of Elder Abuse & Neglect, 17(4), 1–10.

    Google Scholar 

  • Dyer, C., Goodwin, J., Pickens-Pace, S., Burnett, J., & Kelly, P. (2007a). Self-neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team. American Journal of Public Health, 97(9), 1671–1676.

    Google Scholar 

  • Dyer, C., Pickens, S., & Burnett, J. (2007b). Vulnerable elders. The Journal of the American Medical Association, 298(12), 1448.

    Google Scholar 

  • Federal Interagency Forum on Aging-Related Statistics. (2016). Older Americans 2016: Key indicators of well-being. Retrieved from https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf

  • Fulmer, T., Guadagno, L., Bitondo Dyer, C., & Connolly, M. T. (2004). Progress in elder abuse screening and assessment instruments. Journal of the American Geriatrics Society, 52(2), 297–304.

    Google Scholar 

  • Haber, D. (2013). Health promotion and aging: Practical applications for health professionals (6th ed.). Springer. Retrieved from https://market.android.com/details?id=book-_EsSVOyEarMC.

  • Hansen, M., Flores, D. V., Coverdale, J. H., & Burnett, J. (2016). Correlates of depression in community-dwelling older adults with adult protective Services substantiated self-neglect. Journal of Elder Abuse & Neglect, 28(1), 41–56.

    Google Scholar 

  • Iris, M., Conrad, K., & Ridings, J. (2014). Observational measure of elder self-neglect. Journal of Elder Abuse & Neglect, 26(4), 365–397.

    Google Scholar 

  • Kelly, P. A., Dyer, C. B., Pavlik, V., Doody, R., & Jogerst, G. (2008). Exploring self-neglect in older adults: Preliminary findings of the self-neglect severity scale and next steps. Journal of the American Geriatrics Society, 56(Suppl 2), S253–S260.

    Google Scholar 

  • Lachs, M. S., & Pillemer, K. A. (2015). Elder Abuse. The New England Journal of Medicine, 373(20), 1947–1956.

    Google Scholar 

  • Lachs, M. S., Williams, C. S., O’Brien, S., Pillemer, K. A., & Charlson, M. E. (1998). The mortality of elder mistreatment. The Journal of the American Medical Association, 280(5), 428–432.

    Google Scholar 

  • Lachs, M. S., Williams, C. S., O’Brien, S., & Pillemer, K. A. (2002). Adult protective service use and nursing home placement. The Gerontologist, 42(6), 734–739.

    Google Scholar 

  • Lang, F. R. (2001). Regulation of social relationships in later adulthood. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 56(6), P321–P326. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11682585.

    Google Scholar 

  • Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center of Cornell University, & New York City Department for the Aging. (2011). Under the Radar: New York State Elder Abuse Prevalence Study. Retrieved from http://ocfs.ny.gov/main/reports/Under%20the%20Radar%2005%2012%2011%20final%20report.pdf

  • Naik, A. D., Teal, C. R., Pavlik, V. N., Dyer, C. B., & McCullough, L. B. (2008). Conceptual challenges and practical approaches to screening capacity for self-care and protection in vulnerable older adults. Journal of the American Geriatrics Society, 56(Suppl 2), S266–S270.

    Google Scholar 

  • National Center on Elder Abuse. (2018). An Introduction to Elder Abuse for Professionals: Neglect. Retrieved 10 Oct 2018, from https://ncea.acl.gov/whatwedo/education/curricula.html

  • National Research Council. (2003). Elder mistreatment: Abuse, neglect, and exploitation in an aging America. (R. J. Bonnie & R. B. Wallace, Eds.). Washington, DC: National Academies Press. Retrieved from https://www.nap.edu/catalog/10406/elder-mistreatment-abuse-neglect-and-exploitation-in-an-aging-america

  • Pavlou, M., & Lachs, M. (2008). Self-neglect in older adults: A primer for clinicians. Journal of General Internal Medicine, 23(11), 1841–1846.

    Google Scholar 

  • Pickens, S., Otswald, S. K., Murphy Pace, K., Diamond, P., Burnett, J., & Dyer, C. B. (2014). Assessing dimensions of executive function in community-dwelling older adults who self-neglect. Clinical Nursing Studies, 2(1).

    Google Scholar 

  • Pillemer, K., & Finkelhor, D. (1988). The prevalence of elder abuse: A random sample survey. The Gerontologist, 28(1), 51–57.

    Google Scholar 

  • Pillemer, K. A., Mueller-Johnson, K. U., Mock, S. E., Suitor, J. J., & Lachs, M. S. (2007). Interventions to prevent elder mistreatment. In E. N. Haas, L. S. Doll, S. E. Bonzo, J. A. Mercy, & D. A. Sleet (Eds.), Handbook of injury and violence prevention (pp. 241–254). Boston: Springer.

    Google Scholar 

  • Rathbone-Mac Cuan, E. (1992). Self-neglecting elders: A clinical dilemma. New York u.a.: Auburn House.

    Google Scholar 

  • Smith, S., Mathews Oliver, S., Zwart, S., Kala, G., Kelly, P., Goodwin, J., & Dyer, C. (2006). Nutritional status is altered in the self-neglecting elderly. The Journal of Nutrition, 136(10), 2534–2541.

    Google Scholar 

  • Teaster, P. (2002). A response to the abuse of vulnerable adults: The 2000 survey of state adult protective services. [Ebook]. Washington, DC: National Center on Elder Abuse.

    Google Scholar 

  • US Preventive Services Task Force. (2018). Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults. US Preventive Services Task Force Final Recommendation Statement. The Journal of the American Medical Association, 320(16), 1678–1687.

    Google Scholar 

  • Vierthaler, K. (2008). Best practices for working with rape crisis centers to address elder sexual abuse. Journal of Elder Abuse & Neglect, 20(4), 306–322.

    Google Scholar 

  • Dong, X., Simon M. A., & Evans D. A. (2012). Prevalence of Self-Neglect across Gender, Race, and Socioeconomic Status: Findings from the Chicago Health and Aging Project Gerontology 58, 258–268.

    Google Scholar 

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Correspondence to Carmel Dyer .

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Dyer, C., Cannell, M.B., Burnett, J. (2020). Neglect and Self-Neglect of Older Adults. In: Geffner, R., White, J.W., Hamberger, L.K., Rosenbaum, A., Vaughan-Eden, V., Vieth, V.I. (eds) Handbook of Interpersonal Violence and Abuse Across the Lifespan. Springer, Cham. https://doi.org/10.1007/978-3-319-62122-7_86-1

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  • DOI: https://doi.org/10.1007/978-3-319-62122-7_86-1

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