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August 5, 2009

Elder Self-neglect: Medical Emergency or Marker of Extreme Vulnerability?

Author Affiliations

Author Affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

JAMA. 2009;302(5):570-571. doi:10.1001/jama.2009.1136

To address the vulnerability that often accompanies aging, a social contract was established with older individuals in the 1960s through US legislation leading to the creation of the Social Security and Medicare programs. This contract was augmented in 1975 through passage of Title XX of the Social Security Act, which required states to develop and maintain protective service agencies for senior citizens. In most states, these agencies are the first responders to reports of elder abuse, including physical abuse, neglect, and financial exploitation. The most common reason for referral to adult protective services, however, is self-neglect, an ill-defined syndrome characterized by the inability to meet one's basic needs to an extent that it poses a threat to personal health and safety.1,2 The absence of a caregiver distinguishes self-neglect from neglect, which is the most common subtype of elder abuse.3