On this page
- Medication and Substance Use Disorders
- Fraud and Exploitation
- Danger from the Summer Heat
What is self-neglect?
Self-neglect occurs when individuals fail to provide themselves with whatever is necessary to prevent physical or emotional harm or pain. The reasons vulnerable adults neglect their own needs are often complicated and frequently people are unaware of the severity of their situation.
What are the signs?
Some common signs that may indicate self-neglect include:
- Obvious malnutrition
- Being physically unclean and unkempt
- Excessive fatigue and listlessness
- Dirty, ragged clothing
- Unmet medical or dental needs
- Refusing to take medications or disregarding medical restrictions
- Home in a state of filth or dangerous disrepair
- Unpaid utility bills
- Lack of food or medications
What are the causes?
Depression can cloud a person's view of the world and their circumstances, leading to self-neglecting behavior. Often, elderly people lose their motivation to live because they are lonely and isolated. Other reasons that elders neglect themselves can include unexpressed rage, frustration, or grief; alcoholism or drug addiction; and sacrificing for children, grandchildren, or others at the expense of their own unmet needs. Finally, mental or physical illness can quickly result in the deterioration of an elder's ability to adequately provide for their own needs.
One symptom of severe self-neglect may be hoarding. Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter. Countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually piled with stuff. And when there’s no more room inside, the clutter may spread to the garage, vehicles, and yard.
Hoarding ranges from mild to severe. In some cases, hoarding may not have much impact on daily life, while in other cases it seriously affects functioning and the ability to get basic needs met.
Safety concerns focus on instances of living conditions which are hazardous to the health, safety, or well-being of the adult. Hoarding may present as pathways unclear due to large amounts of clutter, animal feces throughout the home, residence is extremely dirty, filled with garbage, or very poorly maintained, and refusing to allow visitors into the residence.
What can be done to help?
Acknowledge and discuss the situation with the elder. Respectfully involve the elder, as much as possible, to determine the cause of their particular case of self-neglect. If appropriate, ask the question, "What would make life meaningful for you again?" Allow them to express their feelings; this could reveal both the cause of the problem and its solution.
Depending on the circumstance, other helpful actions could include: medical or dental treatment; anti-depressant medications and therapy; help them get involved in a favorite hobby or provide transportation to a social group; get them a pet; or get family members involved. When drug or alcohol addiction is the issue, hospital-based treatment is frequently the best solution. Sometimes the cause of self-neglect is directly related to the influence of someone else in their life. Perhaps the elderly individual is sacrificing their own needs in order to care for grandchildren or an ill spouse. Intervening in such situations often requires extreme caution, as the elder may be resistant to any change that threatens the relationship. Use your judgment to weigh the options and involve professionals if it seems appropriate.
Proper use of medication and substance use disorders are concerns that apply to all age groups. Due to several factors, the elderly and people with disabilities are at a greater risk for having trouble in both areas.
Medicine helps people live longer and be more productive in everyday life. However, medications are powerful substances, the consequences of using them can be dangerous, even deadly, and drugs affect people in different ways. Older adults are at risk of misusing medications because they generally have several prescriptions and reactions to medications change as the body ages.
Older adults or people with disabilities need to find out about the drugs they are taking and possible drug interactions. They should inform doctors, pharmacists, and health professionals about their current medications.
Taking several medications can get confusing. In fact, many people forget whether they have taken a medication. One way to ease confusion is to create a chart that contains the name of each medication, its side effects, and when it needs to be taken. The chart should also include a column to be checked-off once a medication has been taken.
If several medications are taken at different times of the day, people may use a container system. A container can be as simple as a cup or egg carton or as fancy as daily multiple pill containers available at drug stores. Caution: People who live in homes with children should be cautious of container systems, since it requires leaving medications out in the open.
Coping with a disability or aging can be difficult. Some people who are elderly or have disabilities may turn to alcohol and drugs. Vulnerable adults must be aware that even small amounts can seriously hurt them. Alcohol can produce a dangerous reaction with acetaminophen, antibiotics, antidepressants, muscle relaxants, or sleep medication.
Alcohol, marijuana, and other drugs affect memory, ability to solve problems, and reaction time. Prolonged use of alcohol, tobacco, and other substances may have serious long-term health effects.
For more information about the risks of substance use disorders, consult with health professionals, Alcoholics Anonymous, or Narcotics Anonymous. If people who suffer from chronic pain fear they are abusing pain medication, they should consult with their doctor to learn about other pain-reduction methods such as special exercises and biofeedback.
What is Financial Exploitation?
Financial exploitation is the illegal or improper use of another person’s money. Taking the money or property of people with disabilities, or who are 65 or older, is a crime. Fraud by friends and family-new “best friends,” "thieving caregivers,” religious con artists, financial abuse by family members—these are examples of exploitation and should be reported.
- Cashing checks without permission;
- Sudden changes in bank accounts or banking practices;
- A person with the account owner withdraws a lot of money;
- Adding extra names on a bank signature card;
- Unapproved ATM card withdrawals;
- Sudden changes in a will or other financial documents;
- Forged signature on financial transactions or property titles;
- Unexplained missing money or valuables;
- Unpaid bills despite having enough money;
- Relatives suddenly claiming rights to a person’s affairs and property.
Identity Theft and Fraud
Identity theft occurs when someone steals your identity to commit fraud. Examples of stealing your identity could mean using personal information without your permission, such as your name, Social Security number, bank account information, or credit card number. If you suspect you, or someone you know, are a victim of identity theft, visit IdentityTheft.gov to learn what to do.
Fraud is a deliberate deception used to secure unfair or unlawful gain. Credit thieves and swindlers use many scams to target innocent people. Report instances of fraud to the Consumer Protection Division of the Texas Attorney General’s office at 1-800-621-0508.
Other types of fraud include home equity fraud, telemarketing fraud, mail fraud, health fraud, money-related fraud, and e-mail and internet fraud.
As a general precaution, never respond to an unsolicited requests that ask for personal financial or identification information. If you believe you have provided sensitive information about yourself through such a scam, immediately notify the financial institution, credit card company, and all three credit bureaus to inform them that you may be the victim of a scam.
Preventing Exploitation Through Money Management
An estimated 500,000 older people in the United States need help with their financial affairs. As a result, a new field called daily money managers is evolving to provide money management services. Daily money managers organize and keep track of financial and medical insurance records; establish a budget; help with check writing and checkbook balancing; and administer the benefits of people who can’t manage their own financial affairs.
For more information, visit the Eldercare Locator at eldercare.acl.gov or 1-800-677-1116. The Eldercare locator is a nationwide, toll-free assistance directory sponsored by Administration on Aging (AoA), an agency of the US Administration for Community Living. This service will refer you to trustworthy local support resources.
According to the Centers for Disease Control, hundreds of people across the United States die and millions more are at risk of getting sick every year from heat-related illness. Most of these occurrences are preventable if only people understood more about the dangers of heat and dehydration, especially in vulnerable populations.
Protecting adults who are elderly or have disabilities from summer heat is everybody’s business. If you know a vulnerable adult who is in danger due to the heat, contact the Texas Abuse Hotline at 1-800-252-5400 or report the incident online at www.txabusehotline.org. If you believe it is a life-threatening emergency, dial 911.
Heat related medical conditions include sunburn, heat rash, heat cramps, heat exhaustion, and heat stroke.
Heat exhaustion occurs when a body has lost a lot of its fluids through sweating, and, as a result, the body overheats. Signs include heavy sweating, pale complexion, muscle cramps, tiredness, weakness, dizziness, headache, nausea, vomiting, fainting, skin may be cool and moist, fast and weak pulse, fast and shallow breathing.
If untreated, heat exhaustion may progress to heat stroke, which is a life-threatening medical condition that can result in damage to the brain and other organs.
Of all people who die of heat stroke, about 80 percent are 50 or older. Deaths attributed to diabetes, lung disease, and hypertension increase to more than 50 percent during heat waves. Heat stroke occurs 12 to 13 times more frequently in people age 65 and older than in younger persons.
Elderly people are often more susceptible to heat exhaustion and heat stroke because they are more likely to have underlying medical conditions, are more likely to take medications that impair the body’s ability to regulate temperature or perspire, and are more susceptible to other risk factors such as mental illness, alcoholism, impaired self-care ability, and unavailability of air conditioning.
What You Can Do If You Are an Adult Who Is Elderly or Has Disabilities
- If possible, stay in an air-conditioned area, either at home or in a public place such as a mall, library, or recreation center. If air conditioning is not available, pull shades over the windows and use cross-ventilation and fans to cool rooms.
- Drink plenty of fluids, but avoid drinks with alcohol, caffeine, or a lot of sugar. Don't wait until you are thirsty.
- Start drinking fluids at least 30 minutes before going out.
- Eat more frequently, but be sure meals are well balanced, cool, and light.
What You Can Do to Help Protect Adults from the Heat
- Visit them at least twice a day and watch them for signs of heat exhaustion or heat stroke.
- Take them to air-conditioned locations if they have transportation problems.
- Make sure they have access to an electric fan whenever possible.
Many APS offices have organized resource rooms to distribute items to the elderly such as donated fans. To find out how you can help, contact the DFPS Volunteer Services Coordinator nearest you – a list is available at www.volunteerdfps.org.