selfneglect

Self-neglect is a behavioral condition in which a person fails to attend to basic personal care and safety needs, such as bathing, grooming, nutrition, medication adherence, medical appointments, housing, and hazard avoidance, leading to potential harm. It is most often observed in older adults but can occur at any age, particularly when cognitive impairment, mental illness, physical disability, or social isolation are present.

Causes and risk factors include cognitive disorders (dementia, delirium), mood disorders (depression), psychiatric illness (schizophrenia), physical illness, sensory impairment, substance use, poverty, and limited social supports. In some cases, self-neglect stems from a conflict between an individual’s autonomy and safety needs, and it may be mistaken for laziness or noncompliance; formal assessment considers decision-making capacity and the person’s values.

Consequences range from malnutrition, dehydration, infections, poor wound care, and medication mishaps to falls, hospitalization, and increased mortality. Self-neglect can also place a burden on caregivers and health systems and may trigger protective services involvement when imminent risk is identified.

Recognition often occurs through routine contact with healthcare providers, social services, or family members. Assessment is multidisciplinary and may review daily functioning, cognition, medical and psychiatric history, living conditions, and safety hazards; there is no single universal diagnostic criterion, and criteria vary by jurisdiction.

Management focuses on person-centered interventions that respect autonomy while addressing safety risks. Plans may include in-home supports (nursing, home health aides, meal services), housing modifications, assistance with medications, treatment of underlying conditions, mental health care, caregiver support, and case management. In cases of impaired capacity or danger, protective services or courts may become involved, guided by ethical and legal standards.