Lack of Social Engagement Is a Risk Factor for Self-Neglect in Older Adults

by November 16, 2009

Twenty Percent of Seniors in Chicago Reported to Social Service Agencies Because of Concern About Suspected Self-Neglect
Seniors who neglect themselves, risking their own health and safety, tend to be individuals with limited social networks and little social engagement, according to a study by Rush University Medical Center.

senior self neglect

The study, currently appearing online in the medical journal Gerontology, is the largest epidemiological study to date examining a wide range of sociodemographic, health-related and psychosocial characteristics associated with elder self-neglect.

“We need to better understand elder self-neglect – who is at risk and why – so that we can find solutions and establish appropriate policies,” said Dr. Xinqi Dong, a researcher and geriatrician at Rush University Medical Center and the study’s lead author. “This is particularly important because reports of self-neglect to social service agencies are rising.

“Moreover, as our aging population is rapidly increasing in size, elder self-neglect will likely become an even more pervasive public health issue.”

The study was based on records drawn from the Chicago Health and Aging Project, a longitudinal epidemiological study of a community-dwelling population of 9,056 individuals 65 years of age and older who live in three communities on Chicago’s South side.

Over the 12-year course of this population-based study, 1,812 of these seniors, or 20 percent, were reported to the Chicago Department of Aging because of concern about suspected self-neglect.

Elder self-neglect is defined by the National Centers on Elder Abuse as “the behavior of an elderly person that threatens his/her own health and safety.” It generally manifests as “a refusal or failure by the person to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication and safety precautions.”

Twice as many women as men and more than seven times the number of African Americans as whites were reported for self-neglect. Those reported, compared with those not reported, tended to be over the age of 80 and have a lower socioeconomic status. The individuals also tended to have nutritional deficiencies, medical conditions and cognitive, physical and psychological deficits.

However, independent of all these factors, lower levels of social well-being – specifically, limited social networks and little social engagement – were major risk factors for self-neglect.

The study has important implications for health and social service professionals, Dong said.

“Professionals who work with the elderly need to be mindful not just of their patients’ health profile, but also of their social well-being, a factor that may put them at risk of self-neglect,” Dong said. “With social services being cut, and community and city resources lacking to help seniors, the problems of isolation can only grow worse.”

Dong will be testifying before the City Council of Chicago on November 13 in support of a resolution seeking to identify measures to address the problem of elder self-neglect. The resolution has been submitted by Alderman Emma Mitts of the 37th Ward and is supported by 29 other Chicago aldermen.

Other researchers involved in the study were Dr. Denis Evans at Rush and Dr. Melissa Simon at Northwestern University.

The study was supported by the National Institute on Aging, a Paul B. Beeson Career Development Award in Aging, The Starr Foundation, the John A. Hartford Foundation and The Atlantic Philanthropies.

Rush University Medical Center includes a 674-bed (staffed) hospital; the Johnston R. Bowman Health Center; and Rush University (Rush Medical College, College of Nursing, College of Health Sciences and the Graduate College).

Rush is currently constructing a 14-floor, 806,000-square-foot hospital building at the corner of Ashland Avenue and Congress Parkway. The new hospital, scheduled to open in 2012, is the centerpiece of a $1-billion, 10-year campus redevelopment plan called the Rush Transformation, which also includes a new orthopedics building (to open in Fall 2009), a new parking garage and central power plant completed in June 2009, renovations of selected existing buildings and demolition of obsolete buildings. The new hospital is being designed and built to conserve energy and water, reduce waste and use sustainable building materials. Rush is seeking Leadership in Energy and Environmental Design (LEED) gold certification from the U.S. Green Building Council. It will be the first full-service “green” hospital in Chicago.

Rush’s mission is to provide the best possible care for our patients. Educating tomorrow’s health care professional, researching new and more advanced treatment options, transforming our facilities and investing in new technologies—all are undertaken with the drive to improve patient care now, and for the future.

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