Nurse perceptions of elder self-neglect

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Yvonne O'Connell Johnson (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Patricia Crane

Abstract: The purpose of this study was to determine how experienced home health nurses perceive elder self-neglect. An additional purpose of the study was to explore steps these nurses employ to intervene when self-neglect is suspected. Self-neglect is a complex phenomenon that is poorly understood. Salient features of this phenomenon include the failure of individuals to take the steps needed to provide for their basic needs, comfort and safety. Common presentations have been described as disheveled, unkempt individuals living in cluttered, filthy homes. Yet, these individuals give no indication there is any cause for concern. Although self-neglect can be found in the literature dating back to the late 1960's, there is a paucity of research of this phenomenon. Previous studies have focused on describing the manifestations of self-neglect, and a few have offered definitions. However, to date, there is a wide range of definitions of self-neglect and thus, a lack of clarity in understanding the phenomenon. Because self-neglect is manifested as a failure to provide for personal needs as well as maintaining the living environment, home health nurses are poised to identify these individuals. However, only three studies were found focused on nurses, and none of those studies focused on nurses who make home visits. This is the first study of self-neglect focused on home health nurse perceptions of the phenomenon. This qualitative, descriptive design of home health nurses (N=16) revealed nurses' perceptions that resulted into five global themes: (a) armor, (b) psychological derivation, (c) seclusion, (d) nonconformity with self-care conventions, and (e) nurses' responses. These nurses could readily identify signs of self-neglect in their clients including nonconformity with self-care conventions and seclusion. They provided their definition for this phenomenon but reported receiving no education on self-neglect either in their pre-licensure programs or since entering practice. These home health nurses identified both facilitators and barriers to providing nursing care to this population, and experienced ethical questions of autonomy and beneficence in providing that care. Study participants attributed self-neglect to psychological issues, although expressed that none of these clients were medically diagnosed with a mental illness or disorder. The results of this study have implications for nursing education and practice as well as public policy decisions. Further studies on self-neglect are needed to develop educational strategies to inform nursing practice. Exploration of the impact that public policy has on these elders who are vulnerable and marginalized is paramount. Nurses should assume lead roles in future studies of self-neglect.

Additional Information

Language: English
Date: 2014
Elderly, Home health, Nursing, Self-neglect
Geriatric nursing $z United States
Home nursing $z United States
Older people $x Care $z United States
Aging $x Psychological aspects

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