Elder Abuse: Who is most at risk of Self-Neglect?

Elder Abuse Awareness Month may be over for 2018, but the impact of elder abuse lasts all year. Elder abuse is defined by the U.S. Administration for Community Living as “any knowing, intentional or negligent act by a caregiver or any other person that causes harm or serious risk of harm to a vulnerable adult.” Elder abuse can be physical abuse, sexual abuse, neglect, exploitation, emotional abuse, abandonment or self-neglect.

Elder abuse can be physical abuse, sexual abuse, neglect, exploitation, emotional abuse, abandonment or self-neglect.

In a recent case study of seven counties in Ohio, we found in each county the most often reported type of elder abuse is self-neglect. This type of abuse involves the failure of a person to perform essential, self-care tasks that threaten his or her own health and safety. The finding of high rates of self-neglect reports in Ohio counties is not surprising as it mirrors national trends identified in a survey conducted by the National Association of Professional Geriatric Care Managers.

Are certain older adults more at risk for self-neglect than others? See what @MuttilloEmily found here Click To Tweet

I wondered if there are certain groups of older adults who are more at risk for self-neglect than others. I found a study based in Chicago that reported three groups are particularly likely to experience self-neglect; African-American males, low income older adults and older adults with less than a high school education. All three of these groups had higher incidence rates compared to white, higher income and more educated groups of older adults.[1]

…three groups are particularly likely to experience self-neglect; African-American males, low income older adults and older adults with less than a high school education.

According to the U.S. Census, an estimated 137,410 African-American males over the age of 55 live in the state of Ohio. With more than 20 percent of Ohio’s African-American males living in Cuyahoga County, practitioners in this region should pay special attention to challenges faced by residents who are black and male. The majority of those living in Cuyahoga County live in the City of Cleveland, where more than 21,000 African-American male residents are over the age of 55. Cleveland has relatively high rates of poverty among older adults, at 21 percent, as well as high rates of those with less than a high school education, at 32 percent. It appears there is likely a high risk of self-neglect among Cleveland’s older adults, particularly black males.

But risk does not have to equate to actual incidence. Strong prevention efforts can reduce the likelihood of abuse occurring.

A leading risk factor for self-neglect is social isolation. Older adults who are not in regular contact with friends, family or social service centers may slip through the cracks. Deterioration in self-care, hoarding behaviors, neglecting of finances and poor medication management are all behaviors that a casual observer may not notice until it reaches a point of crisis. Early intervention through regular social contact often proves to be a strong tool of elder abuse prevention among many populations, including African-American males, low income and less educated older adults.

Risk does not have to equate to actual incidence. Strong prevention efforts can reduce the likelihood of abuse occurring.

While Adult Protective Services (APS) are crucial to invest in to end instances of elder abuse, the prevention of abuse comes from the wider community. Services and programs that are offered through government offices on aging, senior centers, community centers, faith based institutions, health care organizations, recreation leagues as well as other formal and informal networks of older adults play a vital role in reducing social isolation and in turn all types of elder abuse, including self-neglect.

Advocates working the field of elder abuse work tirelessly to bring attention to the issue and increase funding for APS services. This is important work that needs to continue. At the same time, anyone interested in ending elder abuse can play a role by advocating for funding that supports programs designed to socially engage at-risk groups.

 

 

[1] Dong X, Simon M, A, Evans D, A, Prevalence of Self-Neglect across Gender, Race, and Socioeconomic Status: Findings from the Chicago Health and Aging Project. Gerontology 2012;58:258-268