This article originally appeared in the June 10, 2015 issue of the Rutland Herald as 60 Plus: Taking good care of yourself.
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60 Plus: Why don’t they take better care of themselves?
by Janis Hall
Some seniors do not take care of themselves and/or their living spaces because their abilities have declined or because they are affected by physical or mental impairments. We call this “self-neglect.”
Vermont’s Department of Aging & Independent Living defines self-neglect as “an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including (A) obtaining essential food, clothing, shelter and medical care; (B) obtaining goods and services necessary to maintain physical health, mental health, or general safety; (C) managing one’s own financial affairs.”
Sometimes the senior knows that they should make changes to improve their situation, but they are unable to follow through. In other cases, the senior is not able to recognize how their actions (or inaction) jeopardize their health, safety and happiness.
Notice that the description above does not include people who are capable of rational decision-making and follow-through, yet choose to live in conditions that are dirty or unsafe. Such individuals generally have a right to live as they please, so long as they are not endangering anyone else.
But a self-neglecting individual who is genuinely not capable of making healthy decisions and acting on them should be provided with help if they are willing to accept it. Most who get help do so not because they ask for it, but because someone else recognizes the problem and refers them to an agency.
A number of situations may increase the risk for self-neglect in seniors. For example, someone who becomes isolated after a spouse and friends pass away may experience a decline in well-being, especially if they live out of town and can’t drive. A combination of depression, lack of socialization, reduced access to groceries, and less activity can all contribute to a downward spiral of declining health and reduced ability to think clearly and take care of oneself.
Addressing self-neglect can be challenging. Our desire to help them stay safe and healthy must be balanced with the individual’s right to make their own decisions. That’s why Senior Solutions and the Southwestern Vermont Council on Aging use a standard set of assessment questions to determine if the person fits the definition of self-neglecting. Then, as our case managers help create an action plan for the self-neglecting elder, they use a person-centered approach based on listening to the elder and other involved people to find the most respectful and productive route forward.
Another challenge in addressing self-neglect is that it is often brought about by a number of interrelated problems that build upon each other. Underlying causes that may contribute to self-neglect include depression, poor nutrition, medications, dementia, financial troubles and mental illness. That’s why our agencies partner with other organizations to offer a whole spectrum of services and programs that can help self-neglecting seniors get a leg up and improve their lives.
If you’re worried about an elder relative, friend or neighbor who seems to be self-neglecting, here are some ideas that may help:
— Reduce the senior’s isolation. Stay in contact, and try to connect them with other people.
— Listen. Their comments may open up ways for you to suggest help. Respectfully help the elder to understand the options and to choose some positive steps.
— Encourage them to accept help. Some people are proud or stubborn, but once they confide in you, they may listen to your suggestion to get a medical assessment or other help.
— Help them access community services such as volunteer drivers, meals on wheels, senior exercise programs or check-in phone calls. Educate them about what’s available locally, or help them call the Senior HelpLine and describe what they need.
Finally, if you’re concerned about an elder who shows any of the conditions described and you think they do not understand they are at risk, you may call our Senior Helpline at 1-800-642-5119 to talk with our staff about the situation.
The five Area Agencies on Aging responsible for looking into self-neglect among Vermonters age 60 and up can all be reached through the Senior HelpLine. To make a referral for someone under the age of 60, you may contact Adult Protective Services at 1-800-564-1612.
60 Plus is a collaboration between Senior Solutions of southeastern Vermont and the Southwestern Vermont Council on Aging. Both can be reached by calling the Senior HelpLine at 800-642-5119.
Visit us on the web at www.seniorsolutionsVT.org and www.svcoa.org
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