Analysis and treatment of self-neglectful behaviors in three elderly female patients

Three cases of self-neglect in elderly female patients are presented. Ranging in age from 84 to 92, subjects suffered from chronic, non-terminal illnesses, and engaged in such behaviors as refusal to eat, non-adherence to a prescribed therapeutic regimen, and extreme social withdrawal.One lived in the community and two resided in assisted living facilities in Louisville, Kentucky. Initial interviews strongly suggested that the patients' engagement in self-neglect was an inappropriate yet purposeful response to aversive events or other negative stimuli. Goals of treatment were to (1) identify specific factors which precipitated patient use of potentially life-threatening behavior, and (2) employ behavioral methods of intervention in response to the identified precipitators. Outcomes were moderately positive. Behavioral interventions reduced engagement in self-neglectful behaviors for each of the participants to a clinically significant degree. Positive results were maintained during the three-month period following treatment termination.