Care of the Aging Patient: From Evidence to Action
August 3, 2011

Elder Abuse and Self-neglect“I Don't Care Anything About Going to the Doctor, to Be Honest. . . . ”

Author Affiliations

Author Affiliations: Department of Family Medicine, School of Medicine, University of California, Irvine, Orange (Dr Mosqueda); Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois (Dr Dong).

JAMA. 2011;306(5):532-540. doi:10.1001/jama.2011.1085

Elder mistreatment encompasses a range of behaviors including emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. This article discusses the range of elder mistreatment in community-living older adults, associated factors, and consequences. Although self-neglect is not considered a type of abuse in many research definitions, it is the most commonly reported form of elder mistreatment and is associated with increased morbidity and mortality. The case on which this article is based describes a 70-year-old woman who neglects herself and dies despite multiple contacts with the medical community. Despite significant gaps in research, enough is known to guide clinical practice. This article presents the practical approaches a health care professional can take when a reasonable suspicion of elder mistreatment arises. Public health and interdisciplinary team approaches are needed to manage what is becoming an increasing problem as the number of older adults around the world increases.