“The term ‘self-neglect’ means an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self- care tasks including (A) obtaining essential food, clothing, shelter, and medical care; (B) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or (C) managing one’s own financial affairs.  This definition excludes peoples who make a conscious and voluntary choice not or provide for certain basic needs as a matter of life style personal preference or religious belief and who understand the consequences of their decision. “  Vermont Department of Disabilities, Aging and Independent Living, Self-Neglect Task Force (2012)

The work on self-neglect is informed by a study in 2012 that was undertaken to estimate the number of individuals less than 60 and 60 or older in Vermont who could be described as self-neglecting; and to provide information to develop a community response to self-neglect.  Estimating the number of self-neglecting individuals was challenging due to varying definitions, reporting processes and where to make reports and referrals.   However, there were valuable recommendations on developing a community response to self-neglect. 

In 2014 funding was provided to Vermont’s 5 Area Agencies on Aging (AAA) to enhance the response to self-neglect.  Since then the AAAs have been building a community response to self-neglect through raising awareness, education, training and collaboration with old and new community partners.  To identify the services and supports self-neglecting individuals need they have also been using a common assessment tool.

The nature of working with self-neglecting individuals is that it often takes multiple attempts and then visits to establish rapport, a trusting relationship and to complete a risk assessment.  Working with the self-neglecting individual to establish goals follows the completion of the risk assessment.  Goal areas include food, shelter, medical, mental health, financial health or another area of importance to the self-neglecting individual.   

Public Safety

Housing Authorities

Hoarding Task Force

SASH

Local Interagency Team

Hospital Emergency Departments

Home Health Agencies

Community Health Teams

Community Adult Resource Teams

Community Action Agencies

AHS Field Directors

Choices for Care Team Meetings

Mental Health Providers