Elder Self-Neglect In Your Community

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Elder Self-Neglect In Your Community

• Awareness, Intervention, and Reporting for
  Professionals

Presented by INSERT AAA INFORMATION in
collaboration with The Florida Department of
Elder Affairs
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Funding for this program is provided, in part, by
the National Center on Elder Abuse under Grant
90 AM2792 from the U.S. Administration on
Aging, Department of Health and Human Services.
Findings and opinions do not necessarily
represent the views of the Administration on
Aging.
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Introduction

• The goal for this training is to increase
• awareness of elder self-neglect among
• frontline professionals such as
  codes/law/animal
• enforcement officers and aging network staff,
• and to increase reporting of self-neglect to
  the
• Elder Abuse Hotline.

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Headlines in the News

• Massive Cleanup at Cluttered House 7/9/08, KY
• Accused Animal Hoarder Behind Bars in East
  Texas 7/10/09, TX
• Bed-ridden Elderly Woman Found in Neglected
  State 7/18/09, NC
• Woman says she isnt Crazy Cat Lady
  7/31/09, NB
• Portsmouth Woman Found Living in Squalor
  8/14/08, RI
• Elderly Compulsive Hoarder Trapped in Bathroom
  for Three Days 9/3/09 MA

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Self-Neglect Definition

• Self-neglect is the result of an adults
  inability, due to physical and/or mental
  impairments or diminished capacity, to perform
  essential self-care tasks including providing
  essential food, clothing, shelter, and medical
  care obtaining goods and services necessary to
  maintain physical health, mental health,
  emotional well-being and general safety and/or
  managing financial affairs.
• (National Assoc. of Adult Protective Services
  Administrators, 1991)

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APS/Capacity to Consent

• Chapter 415, Florida Statutes describes capacity
  to consent as a vulnerable adult has
  sufficient understanding to communicate
  responsible decisions regarding the vulnerable
  adults person or property and whether or not to
  accept protective services offered by the
  department (of Children Families).
• The Department of Children and Families, Division
  of Adult Protective Services (APS) is responsible
  for investigating reports of self-neglect and all
  types of abuse against vulnerable adults in
  Florida.

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Factors Affecting Capacity to Consent (alone or
in combination)

• Mental Illness
• Developmental Disability
• Organic Brain Disorders
• Physical Illness
• Substance Abuse
• Prescription Drugs

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Statistics Self-Neglect -

• Is the most common type of elder abuse reported
  to and substantiated by APS in Florida and the
  U.S. (Natl Center for Elder Abuse, 1998)
• Accounts for more than half of all calls to APS
  however, it is likely that only 20 or less of
  all elder abuse cases are actually reported.
• Represents 1 in 5 of all abuse cases nationwide.
• Comprised 1/3 of all alleged maltreatments
  reported to the Abuse Hotline for FY 2003-04.
• 52 of self-neglect cases occur among those over
  80 years of age.  
• Nationally recognized experts estimate only 1
  out of every 14 incidents of adult abuse ever
  comes to the attention of authorities.

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Typical Victim Profile

• Female, age 85 or over
• Experiencing dementia. It is estimated that 75
  of self-neglecting elders suffer from some degree
  of confusion (National Elder Abuse Incidence
  Study, 1996)
• Uninvolved with community, family, friends, no
  social anchors
• Difficulty with activities of daily living
• Suffer from untreated chronic illness

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Living arrangement is the single most
important predictor of self-neglect. Living
alone increases the probability of being
categorized as a self-neglect case by 49.
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Why does self-neglect happen?

• Poor health, including physical or mental
  disability
• Financial or social problems
• Fear of being removed from familiar surroundings
• Substance abuse
• ISOLATION is the chief cause

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Indicators Outside the Home

• Overgrown yard and/or garbage around yard
• House in need of repair
• Odor penetrating from inside the house
• Mail/deliveries accumulated outside the house
• Neglected animals in the yard, possibly in large
  numbers (animal hoarding)

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Indicators Inside the Home

• Utilities disconnected
• Interior in need of repair, especially lack of
  toilet facilities
• Garbage, newspapers, etc. accumulated inside the
  house (hoarding)
• Evidence of vermin
• Human/animal excrement present
• Signs of medication mismanagement
• Lack of food and/or water, or presence of spoiled
  food
• Soiled clothing or bed linens
• Neglected animals living in the home

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Indicators Physical

• Obvious absence of necessary medical equipment
• Failure to obtain proper medical care
• Unclothed, or improperly clothed for the weather
• Excessive dirt or odor on the person
• Worsening dementia

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Indicators Behavioral

• Crying, depression, despair
• Nightmares/difficulty sleeping
• Sudden loss of appetite
• Confused and disoriented
• Emotionally numb, withdrawn, or detached
• Exhibits regressive behavior
• Expresses unrealistic expectations about
  circumstances
• Suicidal acts, wanderings, refusing medical
  attention, isolation, substance abuse

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Hoarding

• A debilitating disorder characterized by the
  acquisition of a large volume of possessions that
  clutter living areas to such a degree that living
  spaces cannot be used for their intended
  purposes. In addition, the disorder causes
  impairment in normal life functioning and often
  affects others in the environment.
• - Dr. Randy Frost, clinical psychologist and
  international hoarding expert

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Object Hoarding Signs

• Saving/collecting beyond what is needed or usable
• Value is found in stuff that others do not find
  valuable
• Strong attachments to items for comfort or safety
• Efforts to stop collecting or to discard things
  are unsuccessful
• Fear of losing things
• Stuff interferes with safe and functional use
  of the home
• Others suggest the stuff should be reduced and
  are bothered by it more than the collector
• The stuff is often overwhelming and
  immobilizing

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Animal Hoarding Facts

• Between 700 and 2,000 cases of animal hoarding
  are reported yearly in the U.S. Sixty percent of
  those are repeat offenders.
• Most animal hoarders are single women who are
  widowed or divorced.
• Average age for male or female hoarders is 53 to
  55 years.
• In more than half of the cases, others are living
  in the home, often children, the disabled, or
  elderly family members.
• Hoarders are typically smart and have sympathy
  and possibly enabling from the public.
• There is a strong connection between animal abuse
  and elder abuse.

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INTERVENTION

• Prior to reporting, there are some steps that may
  be taken for early intervention in developing
  self-neglect cases
• Simple personal interventions
• Make personal contact
• Connect individual with a community or
  faith-based group
• Get relatives phone numbers in case of
  emergencies

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INTERVENTION

• Seek community resources either by assisting the
  self-neglect victim in contacting them, or by
  contacting them yourself and sharing the victims
  information
• Community interventions
• Elder Helpline
• Local senior service agencies
• Codes/animal enforcement officers
• Community/faith-based service groups

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Local Resources

• INSERT AAA INFO Agency providing Older
  Americans Act and Community Care for the Elderly
  services.
• Elder Helpline toll-free information, referral
  and assistance number for senior resource
  information.
• Sheriffs Office may be able to do
  well-checks in some cases.
• County Building Zoning Department to report
  codes violations
• Faith-based Groups INSERT FAITH-BASED GROUPS

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Reporting Self-Neglect Why Report?

• Its the law.
• You help the community when you help the
  self-neglecter.
• The victims usually accept help.

• You may be the only person aware enough to help.
• Your report is confidential.

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How to Report

• The Elder Abuse Hotline 1-800-96-ABUSE
  (962-2873)
• 24 Hours a day, 7 Days a week
• Accepts reports of all types of abuse against
  vulnerable adults age 18 and over
• Reporters may request anonymity
• Information given is confidential

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Summary

• Self-neglect causes pain and suffering for
  individuals and communities.
• It is especially underreported in rural
  communities.
• By recognizing self-neglect indicators and
  knowing the resources available for assistance
  and reporting, professionals and community
  members can intervene and prevent further
  degradation of the victims health and wellness.

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For More Information

• INSERT YOUR CONTACT INFORMATION HERE