Self-Neglect Results from Alzheimer’s or Chronic Disease

Self-neglect among persons experiencing memory loss is a significant challenge  for family caregivers and may occur as the result of an underlying cause like memory loss or chronic disease. Many individuals experiencing memory loss have not been formally diagnosed with dementia, Alzheimer’s Disease, Lewy Body Disease or other terms corresponding with a diagnosis of memory loss.  These individuals experience a slow slippage in performing daily activities that then may present as self-neglect.

What is self-neglect? Self-neglect occurs when an individual experiencing memory loss or another diagnosis is unable or refuses to meet his or her own needs for a nutritious diet, appropriate hygiene, taking prescription medication, maintaining a clean home, obtaining ongoing medical care or a long list of other items that most of us perform on a daily basis or regular schedule without much thought.

While Alzheimer’s disease and various types of memory loss are contributors to self-neglect among care recipients other factors contribute to self-neglect. These include isolation, depression, chronic disease and reduced mobility.

For example let’s say that you break a hip and the fracture does not heal such that you are able to return to a prior level of physical activity. Rather than returning to a lifestyle of leaving your home to meet friends and working out at the gym, you begin staying home and participate less in outside activities. The fracture resulted not only in reduced mobility but increased isolation.

Feeling isolated you become depressed and fail to attend routine medical appointments which has a negative effect on your overall health as you also have a diagnosis of high blood pressure and asthma. You see no point in taking your medications. It is easy to see how one health event, a broken hip or a diagnosis of memory loss, quickly changes a life of independence to a life of isolation and possibly self-neglect.

Memory loss results in self-neglect through a loss of executive function which is the ability to have good judgment relative to planning and sequencing activities. A person experiencing memory loss may forget to pay bills or to attend medical appointments. Others forget to eat and experience significant weight loss.  Non performance of simple activities of daily living might be an indicator that your loved one is experiencing memory loss or that another contributing factor, like a health condition, is resulting in an inability to perform self care.

If a loved one is experiencing self-neglect as the result of suspected memory loss or a chronic disease, how do you as a caregiver discuss the concern? Many times it is best to involve the care recipient’s physician so that a formal diagnosis of memory loss or discussion of previously diagnosed chronic disease may be held. Self-neglect as the result of a corresponding health diagnosis is a significant concern that supports discussions about appointing a power of attorney to act in the best interest of the care recipient in the event the care recipient is unable to make good decisions.

When a diagnosis occurs and is discussed in a physician’s office with the care recipient and the family caregiver, practical next steps may be identified. These may include retaining the services of a care advocate, utilizing in home caregivers to provide support with daily activities, or considering a move to an assisted living community. More than likely the care recipient will not respond positively to attempts to change their life, lifestyle or daily routine. These are conversations that must occur repeatedly and over time between the caregiver and the care recipient.

For more information on how to have conversations of care with loved ones, visit my caregiving website, or read my book, The Caregiving Trap: Solutions for Life’s Unexpected Changes.

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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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