The Management of Elderly Self-neglect - Essay Example

 Adult Self-Neglect Introduction Common among elderly individuals with dementia, obsessive-compulsive disorder, affective disorder, and schizophrenia, self-neglect is often defined as the inability of the person to perform self-care activities or actions that can save them from situations or condition that can cause harmful effects to their own health and safety (Amanullah, Oomman, & Datta, 2009; Lauder, 2001). Readily available in the United States, the Adult Protective Services (APS) is a kind of social service given to elderly individuals more than 60 years of age who show signs of abuse, self-neglect, and exploitation. In relation to issues related to elderly self-neglect, a research study was conducted with regards to the best intervention for elderly self-neglect. As such, several articles were compared and contrast concerning the best intervention practices for the management of elderly self-neglect. Eventually, the second part of this essay talks about the application of the identified interventions in the field. Literature Review The main goal of intervention practices for the management of elderly self-neglect should focus on promoting not only autonomy but also improve the quality of life of each patient by increasing their safety, reducing their risk to morbidity and mortality, and improving their overall function as a human being (Culo, 2011). In general, elderly self-neglect can be detected through environmental assessment of their own home. Among the few signs of elderly self-neglect include: (1) unsafe environment such as faulty wirings and infestation of insects (Vinton, 1992; National Center for Elder Abuse, 2005); (2) improper functioning of the toilet and no water supply (National Center for Elder Abuse, 2005); (3) hoarding of containers, clothing, food and papers (Steketee, Frost & Kim, 2001); and (4) “dirty” and “filthy” environment (i.e. human or animal feces on the floor or rotten food, etc.) (National Center for Elder Abuse, 2005; Steketee, Frost & Kim, 2001, p. 180). In the process of establishing a safe living environment for each elderly individuals, it is possible to prevent incidence of hip fracture caused by accidental falls, etc. (Pavlou & Lachs, 2008). In relation to elderly self-neglect, different studies presented different intervention to support their specific needs (Culo, 2011; Pavlou & Lachs, 2008; Torke & Sachs, 2008; Dyer, et al., 2007; Reyes, 2001; Anetzberger & Balaswamy, 1994). For instance, Torke and Sachs (2008) strongly suggest the need to help the elderly individuals establish a safe environment in their own home. In another study, Culo (2011) mentioned that special assistance and support should be given to them in the form of home care services, delivery of meals in their own homes, transportation assistance, housekeeping services, follow-up on medical check-up, and other related day programs. Pavlou and Lachs (2008) strongly suggest that intervention should focus on the need to improve the quality of life of each elderly individual by reducing their risks of developing chronic illnesses and improve their overall life functionality. As such, Pavlou and Lachs (2008) highlighted the need to establish a strong working relationship with the patient so that social care workers can easily negotiate and educate them about the long-term consequences of self-neglect and ways on how to resolve such problem. Other evidence-based intervention for elderly self-neglect includes the following: (1) delivery of meals to the elderly homes, institutional placements, and guardianship by the APS workers (Dong & Gorbien, 2006; Anetzberger & Balaswamy, 1994); (2) the provision or establishment of community care or day care centers (Reyes, 2001); and (3) establish more support groups that offer services related to dressing, bathing, cleaning of homes, laundry, and food supply (Dyer et al., 2007). (See Table I – Summary of the Best Practice or Intervention on Elderly Self-Neglect below) Table I – Summary of the Best Practice or Intervention on Elderly Self-Neglect Culo (2011) Torke and Sachs (2008) Pavlou and Lachs (2008) Dong & Gorbien (2006) Dyer et al. (2007) Reyes (2001) Anetzberger & Balaswamy (1994) Establish a safe environment X Provide special assistance and support (i.e. home care services, delivery of meals in their own homes, transportation assistance, housekeeping services, follow-up on medical check-up, and other related day program) X X X X X Improve quality of life X Reduce risks of developing chronic illnesses X Improve overall life functionality X Establish strong working relationship with the patient X Intervention Utilized in Field In general, the provision of necessary intervention is highly dependent on a case-to-case basis (Culo, 2011). Often times, the intervention strategies used in each patient should be based on the elderly patient’s activities of daily living (ADL) impairment, geriatric syndromes, and morbidities (Naik, Burnett, & Pickens-Pace et al., 2008). Therefore, prior to the application of necessary intervention, there is a strong need to assess the patients’ health and mental condition. In practice, the APS can be extended to vulnerable elderly people who do not have the capacity to decide for themselves (Naik, Pickens, & Burnett et al., 2006). As such, the Mini-Mental State Examination can be use to determine whether or not an elderly individual is capable of making decisions about his own treatment and care (Naik, Lai, & Kunik et al., 2008). In the process of assessing one of my clients, I was able to get a score of 21 out of 30 on the Mini-Mental State Examination. Basically, this figure strongly suggests that the elderly individual is suffering from borderline Dementia. Aside from the score of the Mini Mental Examination, the client was found to be competent and has the right self-determination to avoid being evicted from his own apartment. Having dementia is one of the qualifications of getting special support from the APS. To prevent the client from being evicted from his own apartment, the client was initially taught about the need to keep his apartment free from environmental hazards and dirt which could adversely affect his health in the long-run. However, despite the preliminary intervention strategy used to avoid being evicted from his own apartment, the result of environmental assessment within the client’s apartment was a total failure. This is mainly because of the presence of unsanitary living condition (i.e. feces everywhere, trash were scattered all over the place, dirty dishes can be found on the sink, old food is present on the stove). Since the client’s self-determination to stay in his apartment is very strong, perhaps the best solution in his case is to extend some form of special assistance and support to the client (i.e. home care services such as delivery of meals in their own homes and housekeeping services). Conclusion Most of the past and current studies show that the best intervention or practice for elderly people suffering from self-neglect is to provide them with special assistance and support based on their own specific needs (i.e. home care services, delivery of meals in their own homes, transportation assistance, housekeeping services, follow-up on medical check-up, and other related day program) (Cole, 2011; Dyer et al., 2007; Dong & Gorbien, 2006; Reyes, 2001; Anetzberger & Balaswamy, 1994). To test the client’s mental capacity for APS qualifications, it is best to make use of the Mini-Mental State Examination method. It is given that self-neglect is common among elderly people with dementia, obsessive-compulsive disorder, affective disorder, and schizophrenia (Amanullah, Oomman, & Datta, 2009). Therefore, based on the Mini-Mental State Examination result, social care workers can apply the client to receive special services or support on behalf of elderly people with difficulties in performing ADL. In the process of extending special services to the elderly people, social care workers can effectively play their role without making them emotionally and psychologically suffer from being evicted from their own apartment. References Read More