SELF-NEGLECT

The Activities on these Portfolio Pages correspond with the learning objectives
of the Guided Learning unit published in Nursing Times 104: 24 (17 June 2008)
and 104; 25 (24 June 2008). The full reference list for this unit follows Activity 4.
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Date:

ACTIVITY 1
Learning objective: Define self-neglect
and describe its characteristics
Activity: Outline the various features of
self-neglect.

RESPONSE
Begin your response here.

Nursing Times Portfolio Pages: Self-neglect

ACTIVITY 2

Activity: List the risk factors for selfneglect.

Learning objective: Identify those clients

at greatest risk of developing self-neglect.

RESPONSE
Begin your response here.

ACTIVITY 3
Learning objective: Understand the
steps involved in the identification,
assessment and management of selfneglect.
Activity: Ben Frost* is an 85-year-old
man who lives alone at home. A
concerned neighbour contacts the
community nurse because she is

Nursing Times Portfolio Pages: Self-neglect

concerned about the living conditions of

her neighbour.
Identify the assessment domains and
tools that will guide the nurse and
multidisciplinary team in identification and
assessment of this clients needs.

RESPONSE
Begin your response here.

ACTIVITY 4

neglect.

Learning objective: Identify services or

resources available to manage cases of
self-neglect.

RESPONSE

Activity: Discuss the types of resources

or services that may help clients who self-

Nursing Times Portfolio Pages: Self-neglect

Begin your response here.

FULL REFERENCE LIST

Adams J., Johnson, J. (1998) Nurses
perceptions of gross self-neglect amongst
older people living in the community.
Journal of Clinical Nursing; 7: 547-552.
Burnett, J. et al (2006) What is the
association between self-neglect
depressive symptoms and untreated
medical conditions? Journal of Elder Abuse
& Self-Neglect; 18: 4, 25-34.
Clarke, A. et al (1975) Diogenes
syndrome. A clinical study of gross selfneglect in old age. Lancet; 1: 366-368.
Cooney, C. (2005) Diogenes syndrome a
review Irish Psychiatrist; 6: 10, 13-16.
Department of Health (2000) No Secrets:
Guidance on Developing and Implementing
Multi-Agency Policies and Procedures to
Protect Vulnerable Adults from Abuse.
www.dh.gov.uk/en/Publicationsandstatistics
/Publications/PublicationsPolicyAndGuidan
ce/DH_4008486
Dyer, C.B. et al (2007) Self-neglect among
the elderly: A model based on more than
500 patients seen by a geriatric team.
American Journal of Public Health; 97: 9,
1671-1676.
Dyer, C.B. et al (2003) The clinical and
medical forensics of elder abuse and
neglect. In: Bonnie, R.J., Wallace, R.B.
(eds). Elder Mistreatment. Washington:
National Academic Press.
Esposito, D. et al (2006) Could selfneglect in older adults be a geriatric
syndrome? Journal of the American
Geriatrics Society; 54: 12, 1946.
Gibbons, S. (2006) Primary care
assessment of older adults with self-care
challenges. The Journal of Nurse
Practitioners; 323-328.
Gibbons, S. et al (2006) Self-neglect: A
proposed new NANDA diagnosis.
International Journal of Nursing
Terminologies and Classification; 17: 1, 1018.
Nursing Times Portfolio Pages: Self-neglect

Gunstone, S. (2003) Risk assessment and

management of patients whom self-neglect:
a grey area for metal health workers.
Journal of Psychiatric and Mental Health
Nursing; 10: 287-296.
Halliday, G. et al (2000) Community study
of people who live in squalor. The Lancet;
355: 882-886.
Hurley, M. et al (2000) Adult service
refusers in the greater Dublin area. Irish
Medical Journal; 93: 7, 208-211.
Lachs, M.S. et al (1998) The mortality of
elder mistreatment. Journal of the
American Medical Association; 280: 428432.
Lauder, W. et al (2006) Factors influencing
nurses judgements about self-neglect
cases. Journal of Psychiatric and Mental
Health Nursing; 13: 279-287.
Lauder, W. et al (2005a) A framework for
good practice in interagency interventions
with cases of self-neglect. Journal of
Psychiatric and Mental Health Nursing; 12:
2, 192-198.
Lauder, W. et al (2005b) Self-neglect: the
role of judgements and applied ethics.
Nursing Standard; 19: 18, 45-52.
Maier, T. (2004) On phenomenology and
classification of hoarding: a review. Acta
Psychiatrica Scandinavica; 110: 323-337.
Marson, D.C. et al (2000) Consistency of
physicians legal standard and personal
judgements of competency in patients with
Alzheimers disease. Journal of the
American Geriatrics Society; 48: 9111-918.
Naik, A.D. et al (2008) Assessing capacity
in suspected cases of self-neglect.
Geriatrics; 63: 2, 24-31.
Pavlou, M.P., Lachs, M.S. (2006a) Could
self-neglect in older adults be a geriatric
syndrome. Journal of the American
Geriatrics Society; 54: 831-842.
Pavlou, M.P., Lachs, M.S. (2006b) Letter
to the Editor. Response Letter to Drs.
Reyes-Ortiz and Epositio et al to Journal of
the American Geriatrics Society; 19465

1947.

Nurse Practitioner; 19: 137-142.

Pavlik, V.N. et al (2001) Quantifying the

problem of abuse and neglect in adults analysis of a statewide database. Journal
of the American Geriatrics Society; 49: 1,
45-48.

Reyes-Ortiz, C.A. (2001) Diogenes

syndrome: The self-neglect elderly.
Comprehensive Therapy; 27: 117-121.

Pickens, S. et al (2007) The utility of the

Kohlman evaluation of living skills test is
associated with substantiated cases of
elder self-neglect. American Academy of

Nursing Times Portfolio Pages: Self-neglect

Working Group on Elder Abuse (2002)

Protecting Our Future. Report of the
Working Group on Elder Abuse. Dublin:
Stationery Office.
www.dohc.ie/publications/protecting_our_fu
ture.html

Table 1. Screening questions to assess functional domains of capacity

for self-care and self-protection (Naik et al, 2008)
Domains of selfcare and
protection

Appreciation of
problems

Consequential
problem-solving

Instrumental
activities for daily
living (Ability to
use phone,
shopping, food
preparation,
housekeeping,
laundry, mode of
transport,
responsibility for
own medications
and ability to
handle finances)
Medical self-care:
medication
adherence, wound
care and
appropriate selfmonitoring

Going to the shops

is important for
buying food and
clothing for
everyday living.
Do you have any
problems going to
the shops?

If you need to call

a friend, a taxi or
other services to
take you to the
shops, how would
you do that?

People who forget

to take medication
have poorer health
and may need to
attend doctor more
frequently. Do you
have trouble
remembering to
take medication?

Consider if you
had to have
someone to
supervise your
medication and
watch you take
them. How would
this affect your
everyday life?

Nursing Times Portfolio Pages: Self-neglect

Executive
capacity
(verification of
task
performance)
Ask person to use
the phone n your
presence to call a
friend or taxi to ask
for a lift (person
needs to
demonstrate all
steps for making a
call and getting
information).

With the support of

a community
nurse, carry out a
medication
assessment.
Review medication
bottles and
prescriptions with
the support of
community
pharmacist,