Self-neglect, the inability to provide for oneself the goods or services to meet basic needs, is three times more common than physical abuse or caregiver neglect. Over the past decade our academic geriatrics team has successfully collaborated with Adult Protective Services (APS) to intervene in cases of vulnerable, at-risk elders who self-neglect. Despite the great successes of this collaboration, there is no empirical evidence citing the effectiveness of coupling the Comprehensive Geriatric Assessment Intervention (CGAI) with APS intervention versus APS intervention alone in the management and remediation of elder self-neglect. We plan to conduct a randomized clinical trial (RCT) to test if CGAI and APS intervention is superior to APS intervention alone. Specifically, we plan to recruit 100 APS substantiated cases of elder self-neglect, ages 65 or older, and randomly assign them to either the CGAI and APS intervention group or the usual APS intervention group. Data related to self-neglect status, social, physical, medical and cognitive status and health care utilization and mortality will be collected at baseline and again at 6 months. We intend to test the hypothesis that this approach will improve the quality of care and outcomes provided to these seniors by state protective service agencies.
We can anticipate a sharp rise in the geriatric syndrome of self-neglect in upcoming years due to the burgeoning of our elder population. This study could provide the evidence to link already existing Comprehensive Geriatric Assessment and Intervention (CGAI) teams with local Adult Protective Services workers. Based on our experience of working with APS over the last ten years we believe that the procedures of a CGAI team can easily be integrated into any APS operation, both regionally and nationally, and can reverse the cycle of elder self-neglect, thus improving public health outcomes for our vulnerable elderly population.
| Turner, Anisha; Hochschild, Ann; Burnett, Jason et al. (2012) High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect. Drugs Aging 29:741-9 |
