What to do when a loved one shows signs of personal neglect

Recently I was asked to answer a question that was submitted to the “Ask The Experts” column in the publication Families of Loved Ones. The question and my answer follow:

Q. Someone very dear to us is beginning to show signs of personal neglect. She is often unclean and seems overwhelmed with routine daily tasks. When is it time to begin considering outside help for a loved one?

A. It’s often uncomfortable for family members to broach the subject of their loved one’s declining ability. Sometimes it’s best to enlist the aid of a trusted but objective third party. Carol Mahler, RN, who teaches new aides here at Visiting Homemakers, offers this advice:

Begin by encouraging your loved one to get a comprehensive physical exam from the family doctor or a gerontologist. (* ) Some signs of diminished ability are induced by illness and may not be easy to discern. (In fact, older people don’t always run a fever when they are ill!) Certain illnesses, stress, depression and circulatory problems can result in a person’s neglecting his own personal needs. Medication and/or counseling might help in these situations. Sometimes, the medication a person is already taking is the culprit and adjustments can be made. The doctor and staff may support you by encouraging your loved one to accept help with personal care while his situation is being evaluated. (**)

Another resource is your clergyman or your Church’s health ministry. Some ministries even have an RN who reaches out to church members. In addition, your county Division of Senior Services can guide you to an array of resources, including case managers who specialize in the challenges that Elders and their families face. (***)

Each family is different. Try to identify the dynamics of yours and to use resources and relationships your loved one has already developed and has trust in.

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*A gerontologist is a doctor who is dedicated to the care of elders. You can find a list of gerontologists on your local hospital’s website under “Find a Physician/Geriatrics”

** During the exam, the physician can also look for signs of dementia which, if discovered early, may be delayed or improved through medication. The advantage of early intervention is that your loved one can remain in charge for as long as possible. Some people with dementia in its early stages prefer to put their own care plan in place, taking some of the burden off family members. It’s good to keep in mind that all seniors do not develop dementia. It does not necessarily accompany aging and the sooner it’s treated, the better the chances are of delaying its effects.