You’ve noticed a friend or acquaintance seems to be having some “issues.” She is isolating herself and seldom leaves her home. When you do see her, she seems to have lost weight, is confused and is wearing clothes that are obviously dirty. You can’t be sure if it’s her clothes or her body that smells unwashed. You have not been inside her house but, from what you can see from the front door, it appears cluttered and filthy. You are worried about her but, after all, she is an adult and she gets to make these choices. You really don’t want to interfere or butt in. Besides, if she really needed some sort of help, she would ask for it. Wouldn’t she?

When an individual fails to attend to her own basic needs, such as personal hygiene, appropriate clothing, feeding or tending appropriately to any medical conditions, it is self-neglect, a type of abuse. People can fall victim to self-neglect for a number of reasons, including lifelong patterns of self-neglecting behavior, dementia, illness, malnutrition, overmedication, poverty, substance abuse, depression and isolation. According to the AARP Public Policy Institute, self-neglect is the most common form of elder abuse, representing 40 to 50 percent of cases reported to states’ adult protective services agencies. And, like other forms of elder abuse, it is feared that many more cases go unreported.

Self-neglect can be passive or active. In passive neglect, the individual may not know her needs are not being met. She has no desire to harm herself, but lacks the capacity or the resources to properly care for herself. In active neglect, the individual chooses to ignore her own needs. This may be due to a behavioral health issue such as depression, or she could be sacrificing her self care to care for someone else.

Isolation is a known risk factor for self-neglect. By reaching out through an informal visit, or by volunteering with one of the many programs that provide support to older individuals, you can help to reduce isolation and the risk of elder abuse.

Other actions you can take to help a loved one or friend who may be neglecting herself:

Maintain close ties with her and monitor her situation. Be there for her, but don’t hamper her independence or intrude unnecessarily upon her privacy.

Discuss her wishes regarding health care and long-term care with her.

Contact her area agency on aging to find sources of help in her community.

Explore alternative sources of care, including providing long-term, in-home care yourself.

Don’t offer personal home care unless you thoroughly understand the demands and can meet the responsibility and costs involved.

Don’t ignore your limitations and overextend yourself trying to meet her needs.

If you feel self-neglect has the potential to cause real harm to your friend, report it to the local adult protective services agency, usually housed within her county department of job and family services. If she is in immediate danger of physical harm stemming from self-neglect or some other type of abuse, call local law enforcement right away.

While we all value our privacy and independence, don’t ignore self-neglect. “Butting in” or interfering can help your friend get the care she needs by reducing her isolation and helping her access supports and resources. Call 1-866-243-5678 to be connected to the area agency on aging serving your community.

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