Self-Neglect and Failure to Thrive

At the age of 90, my mother planned to step down from teaching Sunday School and coordinating her church’s homebound ministry. Then, unexpectedly, her church underwent a split, and she felt she had to remain actively involved to keep those ministries going. She continued teaching and visiting for several more years.

When she finally did “retire” from these activities in her mid-90’s she underwent a transformation that greatly concerned me. Suddenly my mother was no longer active socially, and she was always a very social person. She mostly sat at home in her recliner and watched TV or the hummingbirds at the feeder in her yard. Over time she stopped going to lunch with friends. She began to wear the same clothes day after day, and she never ate a real meal except with my brother or me. She bathed infrequently, slept later in the mornings, and had little energy. She lost weight and was thrilled by this, although her doctor told her she should not be losing weight at her advanced age.

Sometimes family caregivers find themselves caring for a family member who doesn’t want to take care of themselves. When someone stops caring for their health or their environment and refuses help from others, their situation may be described as self-neglect. Possible causes for this condition include mental illness, chronic diseases or even a side-effect of some medications. It might also be caused by a loss of motivation due to impaired physical ability.

Failure to thrive is similar to self-neglect but is a medical diagnosis usually indicated by depression, impaired physical abilities, malnutrition, and mental decline. Symptoms may include weight loss, lack of appetite, and inactivity. These symptoms described my mother to a “T,” but her doctor never applied a diagnosis because of my mother’s very social nature. She perked up whenever she went for a doctor’s appointment, smiling and laughing while chatting with the doctor, so nobody ever saw her symptoms.

If your loved one is exhibiting signs of self-neglect or failure to thrive, you probably feel great concern and frustration when he or she refuses to eat, bathe, or otherwise care for themselves; but there are ways to enhance their quality of life.

First, you should talk frankly with your loved one. Ask your father to talk about how he is feeling or what he wishes he could do now. Encourage your mother to stay as active as possible. If she played bridge, invite friends over and ask her to teach you all the game. If your dad enjoyed the coffee club at a local fast food restaurant, why not suggest you both go one morning and see if you can help him to rejoin that group.

If possible, go with your loved one to a doctor’s appointment and ask questions. Ask your mother to tell the doctor about how she sleeps, or what she eats for meals. If your father is depressed, ask the doctor to prescribe a mild anti-depressant. Review a current medication list and ask if any of these medicines could be causing your loved one’s decline. Also, check for organic causes such as a UTI or a blood clot.

If a physical disability has curtailed your loved one’s engagement, ask the doctor if physical or occupational therapy might help improve things like mobility or hand-eye coordination. If incontinence is a problem, encourage your loved one to start wearing protective undergarments. This one thing might give him or her the confidence to venture out and re-engage in life. Fear of bathroom accidents is a significant deterrent to social engagement among the older population.

Finally, click here for more suggestions on how to help with failure to thrive or here for ideas on managing self-neglect.

Also, don’t let yourself fall into self-neglect as a family caregiver! Remember that self-care is one of the things that will help you give great care to your loved ones. Click here for ideas on how to take great care of yourself as a family caregiver!

Chris and I hope you will join our conversation here and share your heart about dealing with self-neglect or failure to thrive in a loved one or yourself. Who knows, your words can make a difference in someone else’s care world!


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