Elder Self‐Neglect and the Justice System: An Essay from an Interdisciplinary Perspective

Abstract

Elder self-neglect is a complex issue for the legal system-one not always easily distinguished from other types of elder abuse, neglect, and exploitation. The issue inherently implicates several disciplines, and although self-neglect is not prosecuted per se, prosecutions of other types of elder abuse, neglect, and exploitation may affect self-neglect as well. In addition, other types of legal intervention, such as guardianship actions, may serve to protect vulnerable older people, but it is critical to ensure that such interventions do not inappropriately infringe on the older person's civil liberties or result in exploitation or worse. There are daunting challenges to doing work in this field-death; ageism; medical, legal, and ethical complexities; and a chronic paucity of funding. It is nevertheless imperative that researchers expand their efforts to elucidate the nature and scope of elder self-neglect; its interplay with other forms of abuse, neglect, and exploitation; and the most effective mechanisms for intervention and prevention. Such efforts, and in particular interdisciplinary approaches to these common problems, are critical to improving care for the nation's older people and assisting millions of families and practitioners.

Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability

“…Consequences if not addressed are poor individual outcomes and financial burdens with rampant recidivism rates and drains on the already over stretched state run APS programs (Dong et al, 2009; Naik, Burnett, & Pickens, et al, 2008). With a person-centered approach to care and targeting individual motivators for change, elders who self-neglect are more likely to engage in services that improves their circumstance (Connolly, 2008; Hildebrand, Taylor & Bradway, 2014; National Committees of Academies of National Statistics, 2010). Behavioral interventions incorporate many of these components while promoting increased self-efficacy and providing intensive follow-up support that fosters a treatable approach to self-neglect and the associated health and mental health needs, including depression (Fulmer, Paveza, VandeWeerd, Fairchild, Guadagno, Bolton-Blatt, & Norman, 2005).…”

A Systematic Evaluation of a Multidisciplinary Social Work–Lawyer Elder Mistreatment Intervention Model

“…In many states, elders are reluctant to participate in research or provide accurate disclosure information due to mandatory reporting ramifications. Debate also persists as to whether participation in elder mistreatment intervention research itself poses increased risk or stress to the subject (Connolly, 2008;Pillemer et al, 2011).…”

“…Challenges are related to ethics, consent, human subject protection rules, mandatory reporting obligations, participant access and recruitment, agency cooperation, and a paucity of resources (Connolly, 2008;Pillemer et al, 2011). With up to 94% of cases remaining hidden in the community, abused elders are a particularly difficult population to recruit .…”

“…Few empirical analyses in the literature have shown the benefits of this intervention orientation. Several calls have been made for evaluations of multidisciplinary elder mistreatment intervention models (Connolly, 2008;National Research Council, 2003).…”

Cognitive Impairment in Older Adults

“…16,17 Issues of neglect and abuse are inherent in the discussion of vulnerable adults and are often the clear-cut situations for clinicians, whereas the other principles require the decision-making proce ss to review less visible alternatives. 16,17 Issues of neglect and abuse are inherent in the discussion of vulnerable adults and are often the clear-cut situations for clinicians, whereas the other principles require the decision-making proce ss to review less visible alternatives.…”