- Written by Barbara Bodzin, Executive Director
- Published: 01 July 2018
Self-neglect: balancing rights versus risks
According to the National Institute of Health, “self-neglect in older adults is an increasingly prevalent, poorly understood problem.” Common situations of self-neglect include issues regarding nutrition, health, hygiene, unmet medical and medication needs, excessive use of alcohol or other substances, home safety, clutter and cleanliness concerns. These manifestations happen at all stages of adult life and may be attributed to loss of financial resources or family supports, social isolation, trauma, declining physical or emotional health, or cognitive impairment. Other times, situations of self-neglect are a result of choices made by the individual associated to values such as independence, culture, privacy, and right to refuse care.
As adults with capacity to direct our own lives, we have the right to fail and the right to make poor decisions. We have the right to choose gratification or self-determination over our personal health and safety. Why should elders be entitled to anything less? LifePath honors the right to self-determination and seeks to provide interventions to mitigate health and safety concerns and improve quality of life. Our goal is to work to understand the unique qualities of each person we serve, consider their values and desires, and look to assess the causes of risk in a person’s current life situation. It is essential to engage in discussion to be sure the elder understands the risk issues at hand and assess the person’s capacity. We need to allow the elder to set the pace for intervention and validate their life decisions.
There are situations where an individual is deemed incapacitated or incompetent and a substitute decision maker, such as a power of attorney, health care proxy or guardian, is needed to intervene. However, the individual’s wishes must remain central in any decisions made on the elder’s behalf. The best interest of the elder must always be taken into consideration when their preference is known or expressed.
Whether it is to the elder, or a substitute decision maker, LifePath provides guidance and assistance to reduce or eliminate health and safety concerns. Change often requires time and incremental steps to work towards alleviating the risks at hand. We work to build respectful and productive relationships in partnership with the elder and their community supports. Success is often achieved through the provision of available resources and services, and in keeping the goal of wellbeing and independence of the elder front and center.