According to the Administration on Aging, about 28% of older Americans, those over the age of 65, live alone. But because life expectancy varies depending on sex (females born this year are expected to live 5 years longer than their male counterparts), these seniors living alone are disproportionately women. In fact, almost half of all elderly women over 75 live by themselves.

As we age, everyone experiences a minimum of physical and mental deterioration. But this decline is particularly troubling for seniors who live alone. For many elderly people, dementia, frailty, and the other effects of aging lead to a corresponding inability to adequately perform the activities of daily living (ADL). Left alone, these seniors can tragically fall into the faultless spiral of self-neglect.

Recent research has led a large contingent of the elder care population to conclude that self-neglect is the most common form of senior abuse.

Signs Of Self-Neglect

Self-neglect refers to any situation in which an elder fails to maintain a healthy, safe lifestyle of their own accord. Obviously, when caregivers fail to provide adequate support, this is not self-neglect; it is simply neglect. In limited instances, self-neglect involves an active refusal to take care of oneself; more often, seniors are simply unable to care for themselves.

Because self-neglect implies a lack of necessary care, it’s helpful to categorize its forms along the lines of basic human needs.

Water & food – seniors who self-neglect often fail to feed themselves, or drink too little water, becoming malnourished or dangerously dehydrated as a result.

Shelter & security – the elderly may neglect their clothing and homes, wearing filthy clothes, or ones that are unsuited to weather conditions. They may also ignore, or be unable to change, unsanitary conditions in their homes.

Basic health – elders who live alone are far less likely to seek medical care than those who live with others.

Seniors who self-neglect are more likely to:

  • Suffer from depression or dementia
  • Suffer from physical infirmities that make movement difficult
  • Have drug problems

If your loved one lives alone, check for the following signs:

  • Poor hygiene
  • Lingering smell of urine or feces
  • Inadequate clothingsenior man who needs help
  • Bed sores
  • Rashes
  • Weight loss
  • Absence of necessary assistance devices, like a wheelchair or cane
  • Unexplained worsening of disorientation
  • Lack of interest in living
  • Untreated illnesses or wounds
  • Extreme changes in behavior
  • Delusional behavior
  • Drug abuse

Your loved one’s home itself can be a source of symptoms, too. Check their residence for:

  • Inadequate food supplies
  • Is the heat on when it should be?
  • Visible trash, debris, or filth
  • Human or animal excrement
  • Infestations
  • Hoarding behavior

What Should I Do?

If you’ve noticed the signs of self-neglect, you can work to reduce your loved one’s isolation. If you can, visit more frequently yourself, or set up a regular phone appointment to talk.

Many private companies offer “Friendly Visitors” programs, where seniors are matched with volunteer workers for a weekly home visit. Most of these companies match volunteers based on a common interest, so conversation should be easy. New York City’s Department for the Aging runs a meal program that delivers fresh foods directly to seniors on a daily, or bi-weekly, basis. Sometimes even the simplest human contact can reduce an elder’s risk of falling into self-neglect. You can find a list of “Friendly Visitor” programs in New York City here.

Confronting self-neglect is most difficult when a senior seems to make active choices in that direction. Refusing necessary medical care is particularly prevalent, but many senior citizens refuse to change their daily patterns in any way. As heartbreaking as it may be, you must always respect your loved one’s wishes. Instead of forcing change upon them, use rational argument and sympathy. Try hard to understand their side of the story.