Future Research: A Prospective Longitudinal Study of Elder Self-Neglect

Authors

  • Carmel Bitondo Dyer MD,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Luisa Franzini PhD,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Mary Watson PhD,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Luis Sanchez MD,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Laura Prati MSW, MEd,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Stacy Mitchell DNP,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Robert Wallace MD,

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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  • Sabrina Pickens MSN, APRN-BC

    1. From the *Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, TexasGeriatrics Program, Harris County Hospital District, Houston, TexasDepartment of Management Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas§Department of the Dean of Health Sciences, Texas Woman's University, Denton, TexasHarris County Medical Examiners Office, Houston, Texas#Department of Epidemiology, University of Iowa, Iowa City, Iowa.
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Address correspondence to Carmel Bitondo Dyer, MD, FACP, AGSF, The University of Texas Medical School at Houston, 6431 Fannin Street, Suite 4.200, Houston, Texas 77030. E-mail: carmel.b.dyer@uth.tmc.edu

Abstract

In almost every U.S. jurisdiction, elder self-neglect is the most common allegation addressed by Adult Protective Service (APS) agencies. Not only is self-neglect common, but this form of mistreatment is an independent risk factor for death. A lack of understanding of the precipitating factors and root causes and of the effect on social and medical systems persists in this field. Research in this area has been limited, because the needs of these vulnerable elderly people are complex and diverse. Moreover, these factors encompass interrelated medical, psychiatric, economic, social, and functional problems.

In 2004, the National Institutes of Health Interdisciplinary Roadmap Initiative provided the means for preliminary exploration of elder self-neglect through the formation of the Consortium for Research in Elder Self-neglect of Texas (CREST). The goals of CREST include to conduct pilot studies, form interdisciplinary working groups, convene a national research conference, and appoint a national external advisory board. CREST orchestrated the work of 35 interdisciplinary investigators to achieve these goals.

CREST researchers have begun to characterize the population of vulnerable elderly people who were reported to APS for neglecting themselves. The pilot studies provided a snapshot of 100 elderly people who had neglected themselves. A proposed next phase could involve a prospective longitudinal study of elderly people with severe self-neglect. This study of the clinical course, the death rate, the causes of death, the occurrence of acute and chronic medical or mental illness, and the costs to the healthcare and social systems would greatly inform the field of elder mistreatment.

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