The Elderly and Self Neglect: Causes and Solutions

Elderly abuse is a serious threat and one of the reasons many people are turning their backs on assisted living facilities and nursing homes, choosing instead to assist their elderly loved ones with aging in place. 

However, actual cases of nursing home abuse are relatively small on a national scale and by rejecting these facilities, Americans could be exposing their elderly parents or spouses to a more common and serious threat: self-neglect.

What is Elderly Self-Neglect?

Elderly self-neglect occurs when an elderly person is unable to look after themselves and meet their most basic needs. They may struggle to wash, clean their clothes, maintain their home, and follow medication schedules.

It can occur for many reasons, both psychological and physical, and may range from mild neglect leading to an individual going several days without a shower to severe neglect, where they don’t eat, drink, or take their medications.

Unlike elder abuse, which is unacted upon them by a caregiver or loved one, self-neglect is caused by the individual themselves.

Signs of Elderly Self-Neglect

If your loved one lives alone or with another elderly relative, and you’re worried they might be neglecting their health, look out for the following signs:

  • Clutter: Is there a lot of clutter in the home? Are bills and dishes piling up, does it look like everything needs a good dusting?
  • Hygiene Problems: Are they bathing regularly, washing and changing their clothes, and paying attention to their hair, skin, and nails?
  • Smell: If they are neglecting their hygiene and not cleaning, dusting, or maintaining their home, there will be a noticeable smell. This is offered referred to as “old-people smell.”
  • Health: Check their health. Pay attention to their waistline and their skin. If they are undernourished, they may show signs of weight loss and vitamin deficiencies. If they are dehydrated, they will have dry skin.
  • Spoiled Food: Check the kitchen fridge and cupboards and look for spoiled food. Not only does it suggest they are not clearing out their fridge or cupboards, but they could be eating those foods and harming their health.
  • Appointments: Speak with their friends, healthcare providers, caregivers, and family members to determine if they are meeting their appointments and doing what is asked of them.
  • How Clean is the Home? A few dusty items are okay, but dirt, bacteria, and mold are another problem entirely. Look at where they sleep, pay attention to the toilet, and check the kitchen sink. This is where they spend most of their time and create the biggest mess. If they are having problems, it will be more noticeable here.

Why is it Common?

Self-neglect is something that occurs in many people who live alone, but it becomes much more common in elderly individuals and may be the result of one or more of the following:


Depression is the reason many younger adults struggle to maintain proper personal hygiene when they live alone. It’s less common in older adults but often causes more problems. 

For instance, an older adult is significantly more likely to succeed in a suicide attempt, and where self-neglect is concerned, they are more likely to become both physically and mentally crippled by the disorder. They may feel like they don’t have the energy or the willpower to meet their most basic hygiene needs, and their pride stops them from opening up to others.

Although people of all ages choose to hide their disorders from their loved ones and care providers, the issue is more common in the elderly. They’re from a different generation, one that was less accepting of mental illness, and as they are used to being the matriarchs or patriarchs of their families, they may not wish to burden their loved ones.

Of course, depression is not a weakness, no one will think less of you for opening up, and you should always speak with someone when you’re feeling low. If you suspect that a family member is depressed, talk to them, remind them there’s nothing to be ashamed of, and try to bring it out of them.

You may just save their life. 

Mobility Programs

Many younger adults get frustrated with their parents when they realize that they are not taking as much care of their homes or themselves as they should be. When this happens, put yourself in their shoes for a moment.

Imagine that you tire easily, have constant aches and pains to deal with, can’t grip or lift anything, and feel like you’ve been to the gym every time you bathe or do a little dusting.

Mobility problems can make these seemingly simple tasks feel impossible. It’s not that they don’t want to, but that they can’t.

Elderly people have much weaker body odor than their younger counterparts and as is so often the case, they are the lasts ones to smell it. They probably don’t think they need regular bathing because they don’t smell, and everyone around them is too polite to say anything.

Too Many Responsibilities

Sometimes, seniors assume more responsibilities than they can handle. They offer their services as personal chauffeurs to their children and as babysitters to their grandchildren. They volunteer to help friends and neighbors and fill their days with classes, crafts, and physical therapy. 

They are used to dealing with other peoples’ problems and filling every minute of their day with chores and tasks, but as they age, they become less efficient, more fatigued, and when they finally have time to themselves, they spend it sleeping or resting.

Younger adults with big families have a lot of stress to deal with as well, and they see their parents as a simple way of relieving the burden. In doing so, though, they could be fixing one problem and creating a much more serious one.

How to Prevent Self-Neglect

To prevent or treat self-neglect in your elderly loved ones, try the following tips:

  • Consider Homecare Services: The options are not “assisted living or nothing.” There are lots of grey areas, including aging in place with help from professional homecare services. These services can cook, prepare, clean, and do laundry, depending on the company and the services chosen.
  • Stop Being so Demanding: Your parents aren’t the only ones who need to accept that they are older and less capable. Their children and grandchildren need to come to the same realization and stop being so demanding of them and their time. It’s good to spend time with them, but not if you’re spending it making demands.  
  • Offer Your Help: Whether you’re buying groceries, collecting medications, cleaning the bathroom, changing the sheets, or washing their clothes, there’s always something you can do to shoulder some of their burden.
  • Renovate their Home: A few simple renovations can go a long way. A step stool or transfer seat can make bath time a breeze, and if that still doesn’t work, a walk-in bathtub takes things to another level. Grab bars, handrails, and anti-slip mats will reduce risks at every turn, while motion alarms and GPS devices protect patients with severe mobility problems and/or dementia.
  • Assistive Devices: If the aforementioned renovations are out of the question, purchase some assistive aids instead. These include sock assists and dressing sticks to make it easy for them to get dressed, as well as smartphones and smart home devices to help with everything from turning on the lights to changing the temperature.
  • Speak with Them: Oftentimes, the best way to help is to ask them what they need and try to understand their situation. It may take some time for them to open up, but if you persist, you will get there eventually.

Self-Neglect: A Serious Problem on the Rise

The lockdowns of 2020 and the rising elderly population has seen a sharp uptick in the prevalence of self-neglect amongst seniors. More often than not, the ones suffering the most are the ones least prepared to change, which means the onus of responsibility often falls on their caregivers and family members.

Keep your eye out for the signs outlined above, make the changes as needed, and if you can’t improve their lives and their health, look into senior care communities, assisted living facilities, and nursing homes.