Self Abuse & Neglect in the Elderly
Self-abuse or self-neglect of an elderly person may occur in a variety of circumstances. The elder may intentionally hurt himrself, or the person may simply fail to care adequately for daily needs. Experts have identified self-abuse and self-neglect in the elderly as a serious problem, but the remedy is not always clear.
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Definitions of Self-neglect and Self-abuse
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The National Center for Elder Abuse defines self-neglect as behavior of an elderly person that threatens that person's health or safety. Behavior can include taking inadequate food or water, not wearing adequate clothes or living in adequate shelter, inadequate personal hygiene and failing to take necessary medication or to follow safety precautions. Symptoms include dehydration, malnutrition, untreated or inadequately treated medical conditions, and unsafe and/or unsanitary living conditions. The term self-abuse may be used to mean the same thing as self-neglect, but it also means that an elderly person intentionally causes harm to himself.
Considerations
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Self-abuse and self-neglect in the elderly presents some difficult issues. If the person commits self-abuse and intentionally harms him or herself, a court may find that the elder is not mentally competent and order a guardian to care for the elder. The situation is much less clear when the person is mentally competent, but does not choose to provide adequate care for him or herself. Generally people are allowed to make bad health choices, such as smoking or drinking to excess, as a form of personal freedom. Elder self-abuse or neglect raises the question of whether the elderly have less personal freedom to make life choices simply because they are old. The National Center for Elder Abuse resolves this issue by specifically excluding the choices of mentally competent elders from the definition of elder self-neglect.
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Scope of the Problem
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Self-abuse or self-neglect in elders has been identified as a major problem. The Public Policy Institute of AARP has estimated that 40 to 50 percent of the reports made to state protective services about elder abuse involve self-neglect on the part of the elderly person.
Elder Justice Act
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The health care laws passed in 2010 included the Elder Justice Act, which provides funding for research, enforcement and prosecution of elder abuse by others. Advocates for the elderly hope that funding for research from this act will help them find answers to help deal with and prevent elder abuse, including self-abuse and self-neglect by elders.
Services
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Self-abuse and self-neglect by the elderly may be alleviated with the provision of adequate services, such as meals, housing, cleaning, low-cost utility services, transportation, and medical care. Advocates hope that funding under the Elder Justice Act will help local agencies provide these services. If competent elders choose not to use these services, states are faced with the difficult decision of whether to declare them incompetent or allow them to choose for themselves.
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