Self-Neglect in Older Adults

When you hear about elder neglect, you may think of someone else (such as a spouse, adult child, in-home care provider or other caregiver) neglecting an older adult’s daily needs. Elder neglect by others is a very serious problem for older adults, but many people do not know that self-neglect is also a major problem that can have very serious consequences.


Self-neglect happens when a person can’t meet their daily essential needs, such as eating, taking medication, bathing, or cleaning up after themselves. Self-neglect can be caused by an underlying mental or cognitive problem, such as dementia or depression, or by common physical problems that people face as they get older. People who have a history of substance abuse or are isolated may be especially at risk for self-neglect. If the underlying problems that are causing the older adult to self-neglect aren’t addressed, the behaviors could get worse over time and put the older adult at risk for illness, injury, and even death.

Many older adults experience self-neglect, but it often isn’t noticed by their caregivers or loved ones. In a survey of care managers who work with older adults, 92% said that self-neglect was a significant problem in their community, and 94% said that it was a problem that is usually hidden and mostly goes unreported.

Many older adults or caregivers may not be aware of what self-neglect looks like. Early warning signs of self-neglect may be difficult to spot. Some signs that a person may be neglecting their daily physical needs include looking dirty or disheveled; smelling bad; having visible wounds; gaining or losing weight from not eating enough or eating a poor diet; not addressing medical issues; and refusing to use necessary medical devices like hearing aids or glasses. Other signs of self-neglect include bills that are not being paid; mail piling up outside the home; their home not being cleaned or pets that are not being cared for; and hoarding.

Older adults experiencing self-neglect can get help. If you suspect that someone you know or care for is experiencing self-neglect, you can report it to your local adult protective services or elder abuse hotline. The National Adult Abuse Hotline is (800) 222-8000, and reports can be made anonymously. You can call 1-800-677-1116 Monday through Friday, 9 AM to 8 PM Eastern to find local agencies that may be able to help your loved one.

Sources: Philadelphia Corporation for Aging

American Society on Aging

US Department of Health and Human Services