For several years now, the Vermont area agencies on aging have been tasked by the state legislature with following up on referrals of self-neglect. We are the only state in the nation to send self-neglect referrals to agencies on aging instead of the state department of Adult Protective Services. This is because the agencies on aging are uniquely positioned to assist those who exhibit self-neglect behaviors with a person-centered approach.
Self-neglect is a general term used to describe a vulnerable adult living in a way that puts their health, safety, or well-being at risk. Vermont’s definition of self-neglect further specifies that the behaviors in question must be the result of diminished capacity related to a medical or behavioral health issue. It is important to distinguish self-neglect from self-determination, the power or ability to make decisions about one’s life without outside compulsion. This means that all older Vermonters have the right to direct their own lives as they age.
Specifically, Vermont defines “self-neglect” to mean:
“An adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including (i) obtaining essential food, clothing, shelter, and medical care; (ii) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or (iii) managing one’s own financial affairs….This excludes individuals who make a conscious and voluntary choice not to provide for certain basic needs as a matter of lifestyle, personal preference, or religious belief and who understand the consequences of their decision.” See 33 V.S.A. § 6203(11) for statutory definitions.
Many people think they have an intuitive understanding of self-neglect, but often fail to consider all the impact an individual with self-neglecting behavior may have on their family and community. Furthermore, many do not understand how some basic services can help save the life of an individual with self-neglecting behaviors and how complicated a self-neglect situation may become, posing challenges in protecting the health and safety of not just the self-neglecting individual, but also their family and neighbors
Self-Neglect is not in itself a diagnosis, but rather a state of being and a collection of behaviors that can be caused by any number and combination of social and medical risk factors. An individual could be considered self-neglecting for a short period of time or decades. Because each individual case of self-neglect is unique, successful interventions must be tailored to the individual, taking into account their personal preferences, histories, medical diagnoses, resources, and social networks. Whether an intervention is successful, and how quickly progress can be made, often depends on the individual’s willingness to engage with a professional(s).
Here at Senior Solutions, building a relationship of trust and respect with the older adult is the gateway to supporting the individual in addressing their self-neglecting behavior. Treating each person with dignity and each situation as unique, we can offer services to help overcome some of the challenges created by their behavior. You may refer potential self-neglect situations in Southeastern Vermont to our HelpLine at 1-802-885-2669.
