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Elders Who Self-Neglect Face Higher Rates of Hospitalizations Suggests Screening Should Be Part of Clinical Practice to Prevent Continuum of Decline

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Summary of this Study
Researchers at Rush University Medical Center and Northwestern University Medical Center in Chicago examined whether elder self-neglect could increase the rates of hospitalizations. Studying 6,864 community-dwelling older adults they determined that the rates of hospitalizations increased in the subset of participants who were reported as self-neglectors even after adjusting for socioeconomic background, cognitive and physical function, and other medical conditions.

Why This Study Was Done
Elder self-neglect is a growing and often unrecognized public health problem.  It is the most common form of elder abuse reported to social service agencies and is associated with an increased risk of premature death. 

According to the National Center on Elder Abuse, elder self-neglect includes behavior by older adults that threatens their personal safety, such as poor personal hygiene, living in unsanitary and unsafe conditions, having inadequate food and clothing, hoarding, and refusing or misusing medications.

What They Found
The researchers evaluated a subset of 1,165 participants from the Chicago Health and Aging Project (CHAP) who had been reported to social services agencies for suspected elder self-neglect during the period of 1993-2005.  All were aged 65 and older and lived in three adjacent neighborhoods on the south side of Chicago.  They were compared to the remaining 5,699 participants without elder self-neglect.

The findings confirmed that those who neglected themselves used more hospital resources with the number of hospitalizations corresponding with the level of severity.  Those with mild levels of self-neglect had annual rates of hospitalization that were 30% higher than those without self-neglect.  Moderate and severe self-neglectors had an increased rate of 57% and 70%, respectively.  The hospitalization data was obtained from the Centers for Medicare and Medicaid System.

“Identifying older adults in the early stages of self-neglect and intervening could be critical if we are to prevent premature morbidity and death in these vulnerable patients,” said XinQi Dong, MD, associate director of Rush Institute for Healthy Aging and associate professor of medicine at Rush University Medical Center and lead study author.  “Many of these hospitalizations could be potentially prevented through improved awareness of self-neglect, routine screening, and interdisciplinary collaboration in clinical and social service settings.  Further studies could better inform practice and policy about elder self-neglect and the coordination of care.”

What You Can Do
Make sure friends, family members, and neighbors visit on a regular basis to assess the home environment and whether physical and emotional needs are being met.  Seek help through social service and community agencies for assistance with shopping, cooking or meal delivery, and cleaning. 

Talk to medical professionals, social workers, and other elder care service providers that the person may see frequently about whether they look for signs of neglect and have interventions in place that include family notification and coordination of follow up care and services.

If you suspect a case of elder neglect or abuse in your community, contact your state Adult Protective Services agency. 

For more information visit the National Center on Elder Abuse.

This summary is from the full report titled, Elder Self-Neglect and Hospitalization: Findings from the Chicago Health and Aging Project.  It is in the February 2012 issue of the Journal of the American Geriatrics Society (JAGS).  The report is authored by XinQi Dong, MD, MPH, Melissa A. Simon, MD, MPH, and Denis Evans, MD.