Rutgers researchers develop new test for elder self-neglect

 Dr. XinQi Dong, lead researcher and director of the Rutgers University Institute for Health, Health Care Policy and Aging Research, said the goal of the study is to improve healthy aging. 
Photo by Photo by Courtesy of Jenny Noonan | The Daily Targum Dr. XinQi Dong, lead researcher and director of the Rutgers University Institute for Health, Health Care Policy and Aging Research, said the goal of the study is to improve healthy aging. 

Rutgers University researchers have developed a new tool to measure self-neglect in elderly populations, according to a study from the Rutgers University Institute for Health, Health Care Policy and Aging Research (IFH).

Self-neglect is the most commonly reported type of elder abuse in the United States and is associated with increased rates of illness, unnecessary hospitalizations and premature death, according to a recent press release.

“According to the National Centers on Elder Abuse, self-neglect is behavior that threatens an elder person’s own health and safety,” said lead researcher and Director of the IFH Dr. XinQi Dong. “Some examples of self-neglect may include when an elder person refuses or fails to provide themselves with adequate food or water, clothing or shelter. They may experience hoarding, poor personal hygiene, inadequate utilities and unsanitary or unsafe living conditions.”

Currently, in-home assessments by health care providers are used to screen for self-neglect in older adults, Dong said. These assessments are often triggered by reports from loved ones or health care providers who become concerned about an elderly person’s health and safety.

“(But), cases of self-neglect may be severe by the time such concerns arise and reports are made,” Dong said. “It is important to consider an elder person’s behavior and health, as well as observations of their environment, in order to determine self-neglect and provide appropriate treatment and services. Such observations may not be possible when health care providers see older adult patients in a primary care office setting, for example.”

The Rutgers team has developed a tool to quantify self-neglect risks without the need for formal in-home visits, Dong said. 

But Bei Wang, survey research assistant at IFH and first author of the study, said the tool is not designed to be a self-assessment or to replace formal in-home assessments.

“We envision a predictive index that may be used by healthcare providers, aging professionals and others who already interact with elder persons frequently, to evaluate whether they may be at risk of self-neglect and help prevent it or provide early intervention and treatment,” Wang said.

After identifying self-neglect, Dong said, it is important to involve family members and loved ones in finding the least restrictive ways to support the elder adult.

“In most states, Adult Protective Services (APS) agencies provide formal responses to elder abuse cases, which include self-neglect cases. Criteria for determining self-neglect and protocols for intervention and treatment may vary across states and agencies, so we do suggest following up with an APS professional for more specifics,” he said.

The goal of the tool and study is to improve outcomes and healthy aging, Dong said. Currently, the risk of premature death is 15 times higher for older adults who experience self-neglect.

“I and other researchers here at the (IFH) have been investigating this topic for the last 20 years,” he said. “It is crucial to understand the broader social and cultural issues that surround elder self-neglect before the situation declines further.”

As the first of its kind for elder self-neglect, Wang said, the tool may be effective in preventing elder self-neglect or providing early intervention in certain populations. The study focused on non-Hispanic, Black and white older adults living in three neighborhoods in Chicago.

The team plans on doing further studies and analyses to understand the tool’s effectiveness in different populations and under-represented minority groups, Wang said.