Senior Abuse Sometimes Is Self-Inflicted

Self-neglect accounts for more calls to adult protective services agencies across the country than any other form of senior abuse, reports the New York Times . "If someone has decision-making capacity, do they have the right to live in squalor?" asks Dr. XinQi Dong at the Rush Institute for Healthy Aging. "As a society, we want to respect autonomy and independence." Dong and his colleagues seek factors such as hoarding, poor personal hygiene, and unsanitary conditions as signs of self-neglect. In studies involving more than 4,600 South Side Chicago residents older than 65, Rush Institute researchers who performed in-home interviews found self-neglect to be common. It was present in 9 percent to 10 percent of men and 7.5 percent to 8.5 percent of women, depending on age. Because some residents refused access to their homes, "it wouldn't surprise me if the prevalence were higher," Dong notes. People with poor health and cognitive impairment, African-Americans, and those with lower income and education have significantly higher rates of self-neglect. Dong observes that people who neglect themselves have higher odds of illness and death as well as emergency room visits and hospitalization, and are prone to other forms of senior abuse. Dong says even when self-neglect is reported, state agencies are "often overworked, understaffed, and underfunded." In addition, he notes that with limited research and a lack of strategies and treatments shown to help, "we really don't know how to deal with these cases."