“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 and the trusting relationship needed to begin a risk assessment. Completion of a risk assessment is over a period of time.