elder self neglect (Diogenes syndrome)
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Introduction
No uniform validated definition[1]
- the individual fails to provide themselves with whatever is necessary to prevent physical of emotional harm or pain
- including, but not restricted to, failure to
- pay bills
- purchase food
- do laundry
- comply with medical instruction
Etiology
- dementia
- depression
- frailty
- other psychiatric disorders[1]
- cognition may be normal in elderly with self-neglect[1]
Epidemiology
- most common category of reports investigated by Adult Protective Sevices[1]
Clinical manifestations
Warning signs:
- malnutrition
- poor personal hygiene
- dirty & unkempt clothing
- excessive fatigue & listlessness
- unmet medical or dental needs
- refusal of medical services expected to improve quality of life
- self endangerment, unsafe behaviors
- lack of food in the home
- home in a state of filth or dispair
- living alone
- dementia
- depression
- hoarding (onset generally < 40 years of age)
Diagnostic procedures
- neurospychologic testing
- loss of executive function & impaired judgement associated with self neglect (non-specific findings)[1]
Complications
Management
- home visit[6]
- treatment of depression with antidepressant (1st step)[1]
- if elderly suspected of self neglect refuses recommendation, ask why prior to referral to Adult Protective Services for concern of self neglect[1]
Notes
- Diogenes syndrome named after the disshelveled philosopher who romed the streets of ancient Greece without clothes (GRS9)[1]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ Mosqueda L, Dong X. Elder abuse and self-neglect JAMA. 2011 Aug 3;306(5):532-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21813431
- ↑ Pavlou MP, Lachs MS. Self-neglect in older adults: a primer for clinicians. J Gen Intern Med. 2008 Nov;23(11):1841-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18649111
- ↑ Dong X, Simon MA, Evans D. Elder self-neglect and hospitalization: findings from the Chicago Health and Aging Project. J Am Geriatr Soc. 2012 Feb;60(2):202-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22283642
- ↑ Dong X, Simon MA, Evans D. Prospective study of the elder self-neglect and ED use in a community population. Am J Emerg Med. 2012 May;30(4):553-61. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21411263
- ↑ 6.0 6.1 6.2 Smith AK, Lo B, Aronson L Elder self-neglect--how can a physician help? N Engl J Med. 2013 Dec 26;369(26):2476-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24369074
- ↑ Dong XQ, Simon M, Evans D. Cross-sectional study of the characteristics of reported elder self-neglect in a community-dwelling population: findings from a population-based cohort. Gerontology. 2010;56(3):325-34. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19786733 Free PMC Article
- ↑ Dyer CB, Goodwin JS, Pickens-Pace S, Burnett J, Kelly PA. Self-neglect among the elderly: a model based on more than 500 patients seen by a geriatric medicine team. Am J Public Health. 2007 Sep;97(9):1671-6. Epub 2007 Jul 31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17666694 Free PMC Article