A new screening tool for self-neglect in community-dwelling older adults: IMSelf-neglect questionnaire

Successful Aging and Self-Neglect Among Community-Dwelling Older People

OBJECTIVE

It was aimed to explore the relationship between successful aging and self-neglect and factors affecting successful aging among community-dwelling older people.

METHODS

This cross-sectional study was conducted with 316 participants aged 60 years and older in a Family Health Center (FHC). The data were collected by using the questionnaire form, Successful Aging Scale and Self-Neglect Scale. The questionnaire form includes sociodemographic characteristics, independence (Katz Daily Life Activities Scale) and well-being status (WHO-5 Well-Being Index), psychosocial support (Multidimensional Perceived Social Support Scale), and depressive symptoms (two questions-complaints such as feeling depressed or hopeless and loss of interest and inability to enjoy life).

RESULTS

Participants had a mean age of 67.5 (SD: 6.5) years, 55.4% were female. A strong positive correlation was determined between successful aging score and self-neglect score (r = 0.741, p < 0.001). Factors affecting successful aging were age, working status, education level, body mass index, physical activity, subjective health perception, health screening status, self-neglect level, depressive symptoms, independence in activities, well-being status, and psychosocial support. Gender, income status, chronic disease presence, cigarette and alcohol use, living alone, and family type did not affect it. According to multivariate linear regression, the factors affecting successful aging were age, psychosocial support presence, and self-neglect level (p < 0.05).

CONCLUSION

Older people have low successful aging and self-neglect scores. Successful aging is better at a young age, in the presence of psychosocial support and a low level of self-neglect. It is recommended to increase the existence of psychosocial support for them and to plan interventions to reduce self-neglect.

Concept analysis of self-neglect in the elderly: a hybrid model

PURPOSE

Clarifying the concept of elder self-neglect.

METHODS

Researchers investigated the concept of elder self-neglect using a hybrid approach, including theoretical, fieldwork, and final analysis phases. After an extensive review of related literature to define the concept of self-neglect and describe its characteristics, the fieldwork phase was carried out to illustrate its empirical features. Accordingly, it led to the extraction of the elder self-neglect attributes from the first two phases.

FINDINGS

Elder self-neglect includes "subjective and objective high-risk behaviors pertinent to physical and spiritual health as well as restricted social interactions, disregarding the living environment, and a lack of compliance to personal hygiene routines that the elderly demonstrate deliberately or unintentionally. Various factors can contribute to such behaviors, including individual features, poor physical performance, elderly-oriented psychological disorders, financial challenges, detrimental stressors, unsuccessful social interactions, inaccessible supportive resources, inadequate educational resources, and inappropriate cultural norms. Consequently, such behaviors result in impaired physical and psychological health status, higher risk of misbehavior, poor quality of life, extra caregiving-treatment burden, and affected mental security in society."

CONCLUSION

Given that elder self-neglect is considered a relatively unknown concept in Iran, the study findings can pave the way for future extensive research in the Iranian context by clarifying the concept. It can play a significant role in developing related tools to design more efficient interventions and improve the quality of nursing care services.

IMPLICATIONS FOR NURSING PRACTICE

The elder self-neglect concept can lead to numerous health-related disorders among the elderly in society. Nurses cannot deal with an unknown phenomenon without exploring and identifying its exact meaning. It is, therefore, imperative to illustrate the different dimensions of this concept to help create a deep understanding among the nurses and perform timely diagnosis and interventional procedures.

Adaptation and validation of the Abrams geriatric self-neglect assessment scale among older Chinese people admitted to the hospital

OBJECTIVES

Elder self-neglect is a global public health problem, and older people admitted to the hospital may have a higher risk of self-neglect due to their deteriorating health conditions. This study aimed to translate, adapt and validate the Abrams geriatric self-neglect assessment scale (AGSS) among older Chinese people admitted to the hospital.

METHODS

Data were derived from a cross-sectional survey of a convenience sample of 452 older people admitted to a general hospital. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the structural validity of the AGSS. Content validity, criterion validity, internal consistency reliability, and test-retest reliability were also conducted to assess the psychometric properties of the scale.

RESULTS

EFA yielded a 6-item one-factor model, which was supported by CFA and explained 44.74% of the total variance. The internal consistency was acceptable (Cronbach α = 0.740), and the test-retest reliability with a 14-day interval was good (intraclass correlation coefficient, ICC = 0.966). Significantly positive correlations with the caregiver-rated elder self-neglect assessment scale (r = 0.648) supported the concurrent validity of the scale. Significant differences in scores between respondents with different ages, marital statuses, educational levels and numbers of chronic diseases demonstrated the discriminative validity.

CONCLUSION

The Chinese version of the AGSS is an easy-to-use, reliable and valid measure with satisfactory psychometric properties. Future studies should recruit a more representative sample of older people in China to verify the applicability of the scale.

IMPLICATIONS FOR PRACTICE

The Chinese version of the AGSS enables clinical staff to accurately screen for and assess elder self-neglect upon hospital admission, which can inform the development of specific interventions and assignment of additional guardianship to those at risk of elder self-neglect.

Self-neglect among older adults with disabilities in Liaoning Province during the COVID-19 outbreak: A cross-sectional study

Background

Self-neglect among older adults is a well-recognized public health issue. During the novel coronavirus disease 2019 (COVID-19), older adults with disabilities may be at increased risk for self-neglect. This study aimed to assess the prevalence of self-neglect and associated factors among older adults with disabilities in Liaoning Province during the COVID-19 outbreak.

Methods

A cross-sectional study was conducted from January 2021 to April 2021. A convenience sample of 230 older adults with disabilities filled out questionnaires that collected data on socioeconomic and demographic characteristics alongside data using the Barthel Index (BI), the Elder Self-Neglect Assessment (ESNA), the Geriatric Depression Scale-Short Form (GDS-SF), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Mini-Mental State Examination (MMSE).

Results

The overall self-neglect rate was 86%. The study revealed that self-neglect correlates positively with the degree of disability (p < 0.001) and depressive symptoms (p < 0.001). In contrast, monthly income (p = 0.002) and perceived social support (p = 0.001) were negatively associated with self-neglect.

Conclusion

During the COVID-19 outbreak, self-neglect has been a serious public health problem among older adults with disabilities. Lower monthly income, decreased physical function, depressive symptoms, and perceptions of poor social support contributed to self-neglect among older adults with disabilities.

Self-neglect among older adults admitted to a Chinese comprehensive hospital in the COVID-19 pandemic era: a cross-sectional study

This study aims to explore the prevalence of self-neglect and associated factors among older adults admitted to the hospital in the COVID-19 pandemic context. The cross-sectional study conducted at a Chinese comprehensive hospital between January and April 2021, 452 older adults were recruited to complete the Abrams Geriatric Self-Neglect Scale, Social Support Rate Scale, FRAIL scale, Barthel index, Patient Health Questionnaire-9, and 10-item Connor-Davidson Resilience Scale. Multivariate logistic regression was used to explore the factors associated with elder self-neglect. The results showed that the prevalence of self-neglect among our sample was 30.3%. Factors that were associated with the risk of elder self-neglect included male, having multiple children (≥4), receiving infrequent visits from children, frailty, and depression. There is a need to screen for self-neglect among older adults admitted to the hospital in the COVID-19 pandemic context. Tailored interventions are warranted to improve the quality of life of older adults.

Development of a Conceptual Framework for Severe Self-Neglect (SN) by Modifying the CREST Model for Self-Neglect

Self-neglect is an inability or refusal to meet one's own basic needs as accepted by societal norms and is the most common report received by state agencies charged with investigating abuse, neglect and exploitation of vulnerable adults. Self-neglect is often seen in addition to one or multiple conditions of frailty, mild to severe dementia, poor sleep and depression. While awareness of elder self-neglect as a public health condition and intervention has significantly risen in the past decade as evidenced by the increasing amount of literature available, research on self-neglect still lacks comprehensiveness and clarity since its inception to the medical literature in the late 1960s. With the burgeoning of the older adult population, commonness of self-neglect will most likely increase as the current incidence rate represents only the "tip of the iceberg" theory given that most cases are unreported. The COVID-19 pandemic has exacerbated the incidence of self-neglect in aged populations and the need for the use of intervention tools for aging adults and geriatric patients living alone, many of which may include in-home artificial intelligence systems. Despite this, little research has been conducted on aspects of self-neglect other than definition and identification. Substantial further study of this disorder's etiology, educating society on early detection, and conceivably preventing this syndrome altogether or at least halting progression and abating its severity is needed. The purpose of this research is to provide a definition of severe self-neglect, identify key concepts related to self-neglect, comprehensively describe this syndrome, present a conceptual framework and analyze the model for its usefulness, generalizability, parsimony, and testability.

Gerontechnological factors affecting successful aging of elderly

In this article, the gerontological factors affecting the successful aging of the elderly have been uncovered, the quality of life and successful aging issues have been related to gerontology and investigated on a different dimension. It has been emphasized that the importance of gerontechnology on the successful aging, creation of awareness through formal and non-formal education, qualitative and quantitative researches should be increased. Qualitative and quantitative researches on the subject were evaluated together, gerontology and gerontechnology were considered together with successful aging, and gerontology functions and ergonomics should be taken into consideration in increasing quality of life. In addition, the concept of geronsafety, a new concept in gerontology, has been put forward, emphasizing the effects of safety on gerontology and successful aging.

Nurses' Perceptions of Factors Influencing Elder Self-neglect: A Qualitative Study

PURPOSE

Elder self-neglect is a global public health issue and should be taken seriously at large. Nurses, usually working directly with elderly patients, have a better understanding of what factors may cause elder self-neglect. In this qualitative study, we explored the influencing factors of elder self-neglect from the perception of nurses in the context of Chinese culture.

METHODS

Face-to-face, in-depth interviews were conducted from November 2018 to December 2018. Purposive sampling was used. Twenty one participants recruited from eight geriatric wards of a general hospital located in Wuhan were interviewed. A content analysis of qualitative nature was performed to analyze the data.

RESULTS

Our conceptual model illustrated the findings based on the three themes of the conflict between personal recognition and social judgment, the choice between current needs and individual beliefs, as well as the compromise between insufficient abilities and limited resources.

CONCLUSION

Nurses together with family members and social workers can help older adults improve their awareness of self-neglect to bridge the gap with social judgment, learn to focus on their own needs, as well as seek as much support as possible. Nurses should also respect the autonomy and self-determination of elder self-neglecters because self-neglect is related to older adults' values. Furthermore, larger studies are needed to quantitatively test and refine the model.