There are so many forms of elder abuse, we rarely consider self-neglect as a subject under that broad topic. While there doesn’t seem to be any reported figures on the actual cases of self-neglect, it’s a widely held opinion by many United States adult protection agencies that it’s fairly wide-spread and the most difficult type of neglect to combat. The American Public Welfare Association, in 1990, defined self-neglect as “the result of an adult’s inability, due to physical and/or mental impairments or diminished capacity, to perform essential self-care tasks.” The difficulty in dealing with this type of abuse is attempting to maintain the integrity and dignity of the individual engaging in the self-neglect while providing necessary services to end the behavior. From the viewpoint of the senior, most often the “protector” is merely being nosy!
Has anyone recently asked you if you were okay? Perhaps, when you asked them why they were questioning, the reply was “oh, you look a little tired,” or maybe, “you seem a little disorganized today,” or “you’re usually so neat and put together,” (implying that on this particular day you are not). Most of us have an adult child, a friend, a visiting nurse, or some other legal adult protective service person that stops by to see how we are. During the visit, they find a reason to check the refrigerator, the laundry room, the bedroom and even the garage or carport. Already, we feel invaded!
As we climb the ladder of aging, no matter how physically fit we try to remain, we begin to find that our bodies continually betray us. Often, those who mean well (our adult children, our friends, our legal “adult protective service people”), forget that dignity, well-being and welfare are the only things to which we can really hang on. While some elders may complain constantly, others become more introverted, attempting to maintain a certain modicum of control over our lives while outside influences spiral out of our control. On fixed incomes, (possibly fixed at a comfortable range of 10 years ago), we attempt to keep groceries, shelter, heat, lights, clothing and medications within our budgetary control. Usually, for the average individual, this balancing act becomes a walk across Niagara Falls on a tightrope!
For instance: one of the indicators of self-neglect is lack of hygiene. This doesn’t mean that if you’ve been out in the vegetable garden and someone stops by, notes that you’re filthy, they’ll turn you in as neglectful. What they’re talking about is if you’ve forgotten to shower for a week or two. A certain pungent odor follows you around and someone is certain to view this as self-neglect. But, why haven’t you showered or bathed? Is it difficult to get in and out of the tub? Maybe one of those well-meaning protectors could add a handrail to your shower. Or, does the shower take so long that you just get tired of standing there? Maybe you could use a shower chair. I’ve used one for over a year and they’re so helpful. Is it harder to get out of the tub than getting into it? Again, one of those shower chairs is highly beneficial - just the right size to glide in and out. No, you aren’t sitting in the water, but it’s near the water and you’re surrounded by water to use for washing your body.
Another self-neglect indicator is a “sudden” lack of financial responsibility. The electric bill was due on the 15th and the grace period went by and you still forgot to pay it. Ouch! Who knew it was the fifteenth anyway? There’s a lot of options to avoid this kind of thing these days. If you’re computer literate, you can set up your checking or savings account to pay those bills automatically. If you think that computers are the downfall of America - (and if you do, then I guess you wouldn’t be reading this, would you?), then there are other ways to avoid having the electric shut off, the water discontinued and the phone stop ringing (I’m not sure this is such a bad thing, hmm?).
I have a friend that must surely own stock in a post-it company. She writes herself little notes on these sticky little pieces of paper and puts them all over the place. When she accomplishes whatever is on the paper, she merely tosses it away. Me? I use the computer, sticking notes in a “To Do” list or on a calendar, but I’ve also taken to grabbing these handy little pieces of paper and sticking them on my refrigerator, my computer screen and in my car. They’re such great little reminders!
So, if you feel that you’ve been a little lax in taking care of yourself, or someone else keeps asking if you’re okay, or if you need a little help, just make a little checklist and try to keep those wonderfully well-meaning protectors looking for someone else to protect! And if you’re one of those well-meaning protectors? Well, before you call in legal services and have your mother/grandmother or great aunt carted off to a multi-level care facility, are you sure that there isn’t a bit more you can do to help? Valuing your cared-for person’s independence and desire to maintain control over their own lives goes a long way to making the quality of life more meaningful.