SELF-NEGLECT OF OLDER ADULTS: HOW CAN ADULT PROTECTIVE SERVICES HELP?

Abstract

Abstract Adult Protective Services (APS) is the only government agency dedicated to investigating elder mistreatment. This frontline agency also provides and coordinates needed services to its clients, but their service effectiveness has not been extensively investigated. Over half of all APS cases investigated are self-neglect. Although no universal definition of self-neglect exists in the literature, self-neglecting older adults fail to perform self-care tasks, such as getting adequate nutrition, maintaining personal hygiene, obtaining medical care, protecting oneself from danger, managing one’s finances– all of which may threaten their health or safety. In partnership with San Francisco and Napa APS, levels of self-neglect were measured using the Elder Self-Neglect Assessment Short-Form during case investigation (before APS interventions) and at case closure (after APS interventions). Services accepted and received by clients at case closure were also documented. A total of 634 older adults’ (on average 77 years old; 50% females) were found to be self-neglecting during the six-month pilot demonstration. Overall, levels of self-neglect decreased after APS interventions (t=-16.97, p<.001). Most common services included care/case management (7%) and mental health services (12%). Services associated with decreased levels of self-neglect included in-home assistance services (b=-1.14, p<.05) and care/case management (b=-0.79, p<.10). Using standardized measures before and after implementing the services needed by older adults allows identification of services that decrease mistreatment. In this study, standardized assessment by APS impacted both practice and research to help advance the understanding of this elder mistreatment type.