Assessing capacity in suspected cases of self-neglect

Geriatrics. 2008 Feb;63(2):24-31.


Self-neglect is a serious and burgeoning public health challenge representing the most common problem faced by Adult Protective Services agencies. Among older adults who are vulnerable to self-neglect, the capacity to make decisions may remain intact. However, the capacity to identify and extract oneself from harmful situations, circumstances, or relationships may be diminished. A key ethical and clinical branch point in identifying older adults at risk for self-neglect involves determining whether the individual can both make and implement decisions regarding personal needs, health, and safety. The Articulate --> Demonstrate method is a practical and efficient way to screen capacity in the setting of suspected self-neglect. Once self-neglect has been identified, common clinical interventions can be targeted to the diagnosed deficits that foster vulnerability to neglect in older adults.

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Aged, 80 and over
  • Decision Making
  • Dementia / diagnosis*
  • Elder Abuse
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Male
  • Mental Competency
  • Self Care / psychology*