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Clearinghouse on Abuse and Neglect of the Elderly (CANE)

Annotated Bibliography
September 2001

CANE (Clearinghouse on Abuse and Neglect of the Elderly) is the nation's largest and most utilized computerized collection of elder abuse materials and resources. With over 3,000 holdings, CANE has the ability to perform customized searches of over 100 keywords producing annotated bibliographies available to the professional community and to the public.

CANE is a service of the National Center on Elder Abuse (NCEA), which is supported by the U.S. Administration on Aging.

The following articles addressing self-neglect are available by request from CANE. Please be aware of each article's file number. The digits following the hyphen in the file numbers indicate the total number of photocopied pages. For example, if the file number is A78-11, then this article (number A78-11) is 11 pages in length. Articles of interest will be forwarded to you at a cost of $.20 per page.

Order from:

Department of Consumer Studies
University of Delaware
Newark, DE 19716

PLEASE NOTE THAT A CHECK MADE OUT TO CANE-UD MUST ACCOMPANY YOUR ORDER. For further information on ordering materials, contact CANE at (302) 831-3525, or at [email protected].

  1. L4386-20
    Bozinovski, S.D.
    Older Self Neglecters: Interpersonal Problems and the Maintenance of Self Continuity
    Journal of Elder Abuse and Neglect; Vol. 12(1), 37-56, 2000

    Keywords: Self-neglect

    Using the Grounded Theory Method, this study examines self-neglect among elders involved with Adult Protective Services. Two social psychological processes were identified, which seem to explain self-neglecting behavior. These processes are "preserving and protecting self" and "maintaining customary control". Of those elders that neglect themselves, it is found that interpersonal problems are the main threat to their identity and self control. This search for continuity seems to be the motivating force and the life goal of these elders.

  2. L4399-7
    Hurley, M., Scallan, E., Johnson, H., & De La Harpe, D.
    Adult Service Refusers in the Greater Dublin Area
    Irish Medical Journal; Vol. 93(7), 207-211, 2000

    Keywords: Self-neglect, Use of Services

    In this study, cross-sectional observations were made in regard to service providers. Service refusers were profiled and the services provided were described. Of the subjects studied, the majority was shown to have traits of poor personal hygiene, suspiciousness, secrecy and hoarding. 47% of the subjects met the criteria for diogenes syndrome. Various forms of support were offered to these individuals including, meals-on-wheels, home aides, and house cleaning services. Despite the offer, 51.9% of the subjects did not accept services.

  3. L4400-2
    Ngeh, J.
    Diogenes Syndrome Presenting with a Stroke in an Elderly, Bereaved Woman
    International Journal of Geriatric Psychiatry; Vol. 15(5), 468-469, 2000

    Keywords: Self-neglect

    This article presents a case of a 79-year old woman who had a stroke. Also presented is a brief description of diogenes syndrome, as well as the incidence rate and how the case of the woman was managed.

  4. L4401-7
    Neville, P., Boyle, A., Baillon, S.
    A Descriptive Survey of Acute Bed Usage for Dementia Care in Old Age Psychiatry
    International Journal of Geriatric Psychiatry; Vol. 14(5), 348-354, 1999

    Keywords: Self-neglect, Alzheimer's/dementia

    The purpose of this study was to examine why patients are admitted to acute dementia care assessment beds. After a 6-month survey period, it was found that the most common reasons for admission were due to behavioral problems, self-neglect, psychotic symptoms and psychiatric illness. The need for acute beds is shown by the large number of emergencies, the reasons for admission and the involvement in mental health services preceding admission. Classification of presenting problems and social circumstances may be more advantageous in assessing outcomes rather than simply looking at diagnosis.

  5. K4252-7
    Thibault, J., O'Brien, J., Turner, L.
    Indirect Life-Threatening Behavior in Elderly Patients
    Journal of Elder Abuse and Neglect; Vol. 11(2), 21-32, 1999

    Keywords: Self-neglect, Suicide, Autonomy

    This article reports the manifestations of indirect life-threatening behavior (ILTB) in a general sense and in relation to a detailed case study of one patient's experience that ultimately led to death. Lack of self-care, refusal to eat, refusal to medicate, and failure to comply with an understood medical regimen are all manifestations of ILTB. The question of why patients resort to the use of dangerous behaviors is discussed with a focus on the possibility that ILTB may be the patient's only source for a feeling of control in their lives.

  6. K4234-9
    Sengstock, M., Thibault, J., Zaranek, R.
    Community Dimensions of Elderly Self-Neglect
    Journal of Elder Abuse and Neglect; Vol. 11(2), 77-93, 1999

    Keywords: Self-neglect, Autonomy

    The impact and effects of self-neglecting elders on their community is examined and discussed. Self-neglect is defined in degrees of severity and these degrees of self-neglect are explored with regard to the elders' proximity to neighbors, community members, fellow patients and caregivers. The effects of self-neglect reach beyond the neglector and the rights of both the neglector and community members are discussed. Case examples are discussed and means for resolving conflicts between lifestyle choices and individuals' rights are suggested.

  7. K4233-11
    Blondell, R.
    Alcohol Abuse and Self-Neglect in the Elderly
    Journal of Elder Abuse and Neglect; Vol. 11(2), 55-75, 1999

    Keywords: Substance abuse, Self-neglect

    Alcoholism and its prevalence among the elderly is discussed as a contributing factor to self-neglect. Awareness of this problem can help professionals identify and intervene in such cases of self-neglect. A table outlining the typical effects of chronic alcohol ingestion on body tissues and organs is included and describes the consequences of damage to the functionality or integrity of these body parts. Screening, treatment, and intervention strategies are presented and discussed in relation to relevant studies.

  8. K4232-12
    Simmons, P., O'Brien, J.
    Ethics and Aging: Confronting Abuse and Self-Neglect
    Journal of Elder Abuse and Neglect; Vol. 11(2), 33-54, 1999

    Keywords: Autonomy, Self-neglect, Ethics

    A specific case involving a 77-year-old male is presented and used as an example of the dilemmas facing health care providers treating older patients. Self-neglect is explored in detail and the issue of reporting and intervention are discussed using real cases as examples to illustrate the often conflicting and difficult choices providers face. The issues of refusal of treatment and determination of decisional capacity are also discussed and recommendations are made to minimize the intrusion of treatment into the patient's life.

  9. K4231-10
    O'Brien, J., Thibault, J., Turner, L. & Laird-Flick, H.
    Self-Neglect: An Overview
    Journal of Elder Abuse and Neglect; Vol. 11(2), 1-19, 1999

    Keywords: Self-neglect, Autonomy, Typologies (definitional problems)

    This report explores the complexity and definitional problems of self-neglect. Some of the issues discussed are: epidemiology, etiology, detection, ethical/legal issues, management/intervention, and outcomes. The main challenges to detection and prevention are discussed with regard to autonomy and personal rights. Previous studies on this subject are compared and general conclusions are reported.

  10. L4402-6
    Bird, P.E., Harrington, D.T., Barillo, D.J., McSweeney, A., et al.
    Elder Abuse: A Call to Action
    Journal of Burn Rehabilitation; Vol. 19(6), 522-527, Nov/Dec 1998

    Keywords: Self-neglect, Risk assessment

    In this study, a one-year retrospective review of injured elders was conducted. It was found that while hospitalized, the patients were poorly screened for abuse and neglect. 11 of the patients studied were able to be placed on a 4-item scale (low risk for abuse, self-neglect, neglect & abuse). 7 patients were victims of self-neglect, 3 patients were victims of neglect and 1 victim of abuse. Patients need to be more aptly screened and professionals must be more aware of the indicators and risk factors.

  11. K4188-11
    Kosberg, J.
    The Abuse of Elderly Men
    Journal of Elder Abuse and Neglect; Vol. 9(3), 69-88, 1998

    Keywords: Self-neglect, Lesbian/Gay, Gender,

    This article discusses the high rates of self-abuse by elderly men and their high risk of abuse by others when they are lonely, living in inner cities, incarcerated, or homosexual. Abuse of elderly men occurs in domestic settings by spouses, children, relatives, and friends, and in institutional settings by paid employees. The article discusses varying situations that precede occurrences of abuse of elderly men that affect the quality of their lives.

  12. J4066-5
    Lachs, M.S., Williams, C.S., O'Brien, A., et al.
    The Mortality of Elder Mistreatment
    Journal of the American Medical Association; Vol. 280(5), 428-432, August 5, 1998

    Keywords: Self-neglect, Physical abuse, Frail elderly, Risk assessment

    This article describes a study whose purpose was to examine the mortality associated with elder mistreatment in a group of community dwelling older adults. The longitudinal study found that elderly adults who were mistreated were more likely to be dead at the end of the 13-year follow up period than other groups of elderly adults who either self-neglected or had not experienced mistreatment. Further findings are discussed.

  13. L4403-4
    Jackson, G.A.
    Diogenes Syndrome-How Should We Manage it?
    Journal of Mental Health; Vol. 6(2), 113-116, 1997

    Keywords: Self-neglect, Autonomy

    In this article, Diogenes Syndrome (self-neglect of the elderly) is discussed. Included is the description of Diogenes Syndrome, history of it and its management. The role of persuasion should be emphasized as a management tool.

  14. K4272-15
    Gruman, C., Stern, A., Caro, F.
    Self-Neglect Among the Elderly: A Distinct Phenomenon
    Journal of Mental Health and Aging; Vol. 3(3), 309-323, 1997

    Keywords: Self-neglect, Victim profile

    Self-neglecting elders and victims of elder abuse both suffer maltreatment. The focus of this study is an exploration of the similarities and differences between elders suffering at the hands of others and elders initiating their own maltreatment through self-neglect. These elders are also compared to a general population of elders. The study suggests that current theories regarding elder abuse may not adequately address self-neglect since they typically have been developed using a perpetrator-victim model. This comparison between self-neglecting elders and abused elders seeks to define characteristics shared by the groups and clarify areas where distinct differences could be a source of further research. Victim characteristics and victim profiles are presented and a discussion of practice and policy issues is included.

  15. K4330-10
    Lustbader, W.
    Self-Neglect: A Practitioner's View
    Aging; Vol. 367, 51-60, 1996

    Keywords: Self-neglect, Substance abuse

    This article discusses self-neglect as seen from a practitioner's perspective. A number of possible reasons for self-neglect are discussed along with possible interventions in dealing with them. Some of the possible reasons for self-neglect include the loss of the will to live, the violations of medical restrictions, and addiction to drugs and alcohol.

  16. K4333-6
    Rathbone-McCuan, E.
    Self-Neglect in the Elderly: Knowing When and How to Intervene
    Aging; Vol. 367, 44-49, 1996

    Keywords: Self-neglect, Intervention

    This article is based on the book "Self-Neglecting Elders: A Clinical Dilemma". This article begins by discussing the difficulty with intervention due to the differing ideals of self-neglect held by practitioners and elders. Also touched upon are some of the reasons for self-neglect other than psychiatric problems and the various facets of self-neglect practitioners need to keep in mind when considering intervention.

  17. K4334-2
    Duke, J.
    Study Found 79% of Adult Protective Services Cases Were Self-Neglect
    Aging; Vol. 367, 42-43, 1996

    Keywords: Self-neglect, Mentally impaired

    Discussed in this article is the finding of a correlation between poverty and neglect, as reported in a previous study. This article contends that this finding may be inaccurate and that there seems to be a more direct link between self-neglect and mental impairment. Also provided is a brief profile of individuals who suffer from self-neglect.

  18. L4398-18
    Longres, J.F.
    Self-Neglect Among the Elderly
    Journal of Elder Abuse and Neglect; Vol. 7(1), 69-86, 1995

    Keywords: Self-neglect, Alzheimer's/dementia, Substance abuse

    This study examines the differences between cases of self-neglect and cases of maltreatment by others. These cases were collected by combining three years of data from the Wisconsin Elder Abuse Reporting System with in-depth interviews from elder abuse investigators. It was found that living arrangements were associated with the type of maltreatment. Also discussed were mental illness, drug/alcohol problems, and dementia. Data also suggested that family context may play a significant role in maltreatment. The impact of these findings on policy, programs and practice is also discussed.

  19. L4397-18
    Longres, J.F.
    Self-Neglect and Social Control: A Modest Test of an Issue
    Journal of Gerontological Social Work; Vol. 22(3/4), 3-20, 1994

    Keywords: Self-neglect, Use of Services

    Both qualitative and quantitative data is used in this study to examine whether service delivery to self-neglecting elders is perceived as intrusive by those elders. The conclusions reported include: investigators found that those elders referred for self-neglect tend to feel intruded; self-neglect tends to be substantiated more often than other kinds of abuse; there is no relationship between type of maltreatment and the acceptance of services; and there seems to be an association between the impairments experienced and the willingness to cooperate.

  20. H3365-42
    National Association of Adult Protective Services Administrators Virginia Department of Social Services
    A National Study of Involuntary Protective Services to Adult Protective Service Clients

    Keywords: Intervention, Self-neglect, Adult Protective Services

    A national study of the provision of involuntary protective services by APS programs was done through a questionnaire gathering information regarding: 1) the frequency with which APS clients are served without their consent; 2) whether self-neglect clients are more likely than other APS clients to be served involuntarily; 3) the source of authority for APS programs to intervene in lives of persons who do not choose the intervention; 4) the type of services provided involuntarily; 5) the nature and extent of public concern about involuntary services; and 6) protection of rights of incapacitated persons served by APS programs.

  21. I3690-12
    Longres, J.
    Race and Type of Maltreatment in an Elder Abuse System
    Journal of Elder Abuse and Neglect; Vol. 4(3), 61-83, 1992

    Keywords: African-Americans, Self-neglect, Neglect

    This study examines the relationship between race and types of maltreatment experienced by the elderly. The study did show that race added significantly to the knowledge of maltreatment. Black elderly were less likely to experience self-neglect and more likely to experience neglect by others. No evidence was found to indicate blacks were at any more risk than whites for abuse. However, since blacks may very well be disproportionately represented among neglect cases, service providers will have to be exceptionally careful to ensure against problems of discrimination in the service resources for blacks.

  22. I3734-30
    Bozinovski, S.D.
    Self-Neglect Among Elders in the Community
    Dissertation Proposal; 1991

    Keywords: Self-neglect

    The focus of this study is self-neglect, in particular, the self-neglecting behavior of older persons in the community who have come to the attention of the adult protection system.

  23. I3676-10
    Keigher, S.
    Informal Supportive Housing for Elders: A Key Resource for Preventing Self-Neglect
    Journal of Elder Abuse and Neglect; Vol. 3(2), 41-59, 1991

    Keywords: Self-neglect, Frail elderly, Caregiver-other

    This study examines how effective care of the poor, frail elderly with no family seems to happen naturally in neighborhoods and households. Based on records from city emergency services, there is a high proportion of elders receiving care from non-relatives. Ethnographic research highlights important features of informal care that could never be replaced by formal interventions.

  24. E2796-5
    Dupree, L.W.
    Comparison of Three Case-Finding Strategies Relative to Elderly Alcohol Abusers
    Journal of Applied Gerontology; Vol. 8(4), 502-511, 1989

    Keywords: Self-neglect, Substance abuse

    A demonstration project was developed to determine the effectiveness of three case-finding strategies that can be used to locate elder alcohol abusers and aid in linking these abusers to a treatment program. The three strategies employed consisted of; 1) a formal caregiver network; 2) a general public awareness campaign; and 3) a community health clinic outreach program. Findings suggest that the first two are the most cost effective and formal caregiver referrals is the most effective overall.

  25. E2723-15
    Reed, P. & Leonard, V.
    An Analysis of the Concept of Self-neglect
    Advanced Nursing Science; Vol. 12(1), 39-53, 1989

    Keywords: Self-neglect, Theories

    This article presents the results of a concept analysis of self-neglect as a first step toward further theory developments, research, and eventual practical applications. In recent statewide surveys, self-neglect was found to be one of the most prevalent forms of "elder abuse".

  26. D2542-37
    McKibben, M.
    Older Battered Women Project
    Administration on Aging; 1988

    Keywords: Older battered women, Self-neglect, Needs assessment,

    This packet covers several issues regarding older battered women. First, a philosophical essay on the lines and connections between decades of physical abuse and eventual self neglect in later life; second, an article which examines the shortcomings and strengths of current service delivery to older victims with recommendations on age sensitive programming in the battered women's movement; third, a summary of the unique needs that older women face in the criminal justice system; fourth, interview summaries which include brief descriptions of ten women's abusive relationships; fifth, statistics that negligent both state and national data regarding the profile of abuse and the need for age sensitive services. Included is a case example of a self-neglecting 82 year old woman.

  27. E2778-6
    McIntosh, J. & Hubbard, R.
    Indirect Self-Destructive Behavior Among the Elderly: A Review with Case Examples
    Journal of Gerontological Social Work; Vol. 13(1), 37-46, 1988

    Keywords: Self-neglect, Suicide

    This study reviews literature on indirect self-destructive behavior among the elderly. Elders engage in suicide and also employ covert and slow methods of self-destruction. Case examples illustrating indirect self-destructive behavior (ISDB) are presented here to raise awareness of this phenomenon and its manifestations.

  28. K4179-8
    Mixson, P.M.
    Self-Neglect: A Practitioner's Perspective
    Journal of Elder Abuse and Neglect; Vol. 3 (1), 35-42; 1991

    Keywords: Self-neglect

    This article provides practitioners with functional guidelines to address cases of self-neglect. Recognizing the dilemma of trying to assist an unwilling client while respecting his or her autonomy, the article focuses on interventions designed to overcome the client's resistance to help. A thorough understanding of the individual, interpersonal and environmental conditions that underlie the client's resistance, is an essential first step. Techniques to establish a trusting and cooperative relationship, such as validation, metaprograms and exchange strategies are detailed.

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