Análisis de la autonegligencia en las personas mayores
[Analysis of elder self-neglect]
Autoría: Touza Garma,Carmen
Datos profesionales del autor/a: Universidad de Islas Baleares
Correspondencia: Carmen Touza. Departamento de Pedagogía y Didácticas Específicas (Universidad de las Islas Bañeares. Tfno: 971172492. Email: carmen.touza@uib.es. Fax: 9711731.90. Cra. de Valldemossa Km 7,5. Edificio Guillmen Cifre de Colonya. 07122-Palma
Recibido: 5/2/2019
Revisado: 22/4/2019
Aceptado: 21/5/2019
Publicado: 31/5/2019
Resumen
Este artículo analiza la autonegligencia en las personas mayores, con el objetivo de promover la investigación y la intervención ante este desafío planteado a los servicios socio-sanitarios por el envejecimiento de la población. Se examinan aspectos sobre su conceptualización y la heterogeneidad de las personas mayores autonegligentes. Se analizan datos de prevalencia, los resultados de las investigaciones sobre las consecuencias producidas y los estudios que muestran que se trata de un síndrome geriátrico multifactorial. Se discute la dificultad de las intervenciones para conseguir el equilibrio entre los derechos de las personas mayores y la obligación de los profesionales de garantizar su bienestar. Finalmente, se expone la tendencia actual a establecer una atención integral a la salud física y mental en el nivel de atención primaria y a hacer participar a las personas en su autocuidado.
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Palabras Clave
Autonegligencia, Personas mayores, Atención primaria integral.
Abstract
This article analyses self-neglect in elder people, aiming to promote research and intervention in response to this challenge posed to socio-health services due to the aging of the population. Different aspects related to the conceptualization of self-neglect and the heterogeneity of self-neglecting seniors are examined. Prevalence data, research results about consequences, and research results reflecting a multifactorial geriatric syndrome are analysed. The difficulty of interventions in order to balance the elder people´s rights and professionals’ obligation to guarantee their well-being is discussed. Finally, the current tendency to establish an integrated care to physical and mental health at the primary care level and to involve people in their self-care is exposed.
Key Words
Self-neglect, Elder people, Integrated primary care.
Referencia Normalizada (cómo citar este artículo)
Touza, C. (2019). Análisis de la autonegligencia en las personas mayores. Trabajo Social Hoy, 87, 73-84. doi: 10.12960/TSH.2019.0000.
Texto del Artículo
Referencias
Band-Winterstein, T., Doron, I., y Naim, S. (2012). Elder self neglect: A geriatric syndrome or a life course story? Journal of Aging Studies, 26, 109–118. doi: 10.1016/j.jaging.2011.10.001
Braye, S., Orr, D., y Preston-Shoot, M. (2015a). Learning lessons about self-neglect? An analysis of serious case reviews. Journal of Adult Protection, 17, 3-18. doi: 10.1108/JAP-05-2014-0014
Braye, S., Orr, D., y Preston-Shoot, M. (2015b). Self-neglect policy and practice: research messages for practitioners. London: Social Care Institute for Excellence.
Braye, S., Orr, D., y Preston-Shoot, M. (2015c). Serious case review findings on the challenges of self-neglect: indicators for good practice. Journal of Adult Protection, 17, 75-87. doi: 10.1108/JAP-05-2014-0015
Braye, S., Orr, D., y Preston-Shoot, M. (2017). Autonomy and protection in self-neglect work: The ethical complexity of decision-making. Ethics And Social Welfare, 11, 320-335. doi: 10.1080/17496535.2017.1290814
Burnett, J., Dyer, C. B., Halphen, J. M., Achenbaum, W. A., Green, C. E., Booker, J. G., y Diamond, P. M. (2014). Four subtypes of self-neglect in older adults: Results of a latent class analysis. Journal of the American Geriatrics Society, 62, 1127-1132. doi: 10.1111/jgs.12832
Causapié, P., Balbotín, A., Porras, M., y Mateo, A. (Dirs.) (2011). Envejecimiento activo. Libro Blanco. Madrid: Ministerio de Sanidad, Política Social e Igualdad, Secretaría General de Política Social y Consumo e Instituto de Mayores y Servicios Sociales (IMSERSO).
Day, M. R., Mulcahy, H., y Leahy-Warren, P. (2016). Prevalence of self-neglect on public health nurses caseloads. British Journal of Community Nursing, 21, 31-35. doi: 10.12968/bjcn.2016.21.1.31
Day, M.R., Mulcahy, H., Leahy-Warren, P., y Downey, J. (2015). Self-neglect: A case study and implications for clinical practice. British Journal of Community Nursing, 20, 110-115. doi: 10.12968/bjcn.2015.20.3.110
Dong, X. (2014). Self-Neglect in an elderly community-dwelling U.S. Chinese population: Findings from the population study of Chinese Elderly in Chicago Study. Journal of The American Geriatrics Society, 62, 2391-2397. doi: 10.1111/jgs.13140
Dong, X. (2016). Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population. Archives of Gerontology and Geriatrics, 64, 82–89. doi: 10.1016/j.archger.2016.01.007
Dong, X. (2017). Elder self-neglect: Research and practice. Clinical Interventions in Aging, 12, 949–954. doi: 10.2147/CIA.S103359
Dong, X., y Simon, M. (2013). Association between elder self-neglect and hospice utilization in a community population. Archives of Gerontology & Geriatrics, 56, 192-198. doi: 10.1016/j.archger.2012.06.008
Dong, X., y Simon, M. (2016). Prevalence of elder self-neglect in a Chicago Chinese population: The role of cognitive physical and mental health. Geriatrics & Gerontology International, 16, 1051-1062. doi: 10.1111/ggi.12598
Dong, X., Simon, M.A, y Evans, D. (2012). Elder self-neglect and hospitalization: Findings from the Chicago Health and Aging Project. Journal of the American Geriatrics Society, 60, 202–209. doi: 10.1111/j.1532-5415.2011.03821.x
Dyer, C.B., Goodwin, J.S., Pickens-Pace, S., Burnett, J., y Kelly, P.A. (2007). Self-neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team. American Journal of Public Health, 97, 1671-1676. doi: 10.2105/AJPH.2006.097113
Dyer, C.B., Kelly, A., Pavlik, V.N., Lee, J., Doody, R.S., Regev … Smith, S.M. (2006). The making of a Self-Neglect Severity Scale. Journal of Elder Abuse & Neglect, 18, 13-23. doi: 10.1300/J084v18n04_03
Gibbons, S., Lauder, W., y Ludwick, R. (2006). Self-neglect: A proposed new NANDA diagnosis. International Journal of Nursing Terminologies and Classifications, 17, 10-18. doi: 10.1111/j.1744-618X.2006.00018.x
Halphen, J.M., y Burnett, J. (2014). Elder abuse and neglect: Appearances can be deceptive. Psychiatric Times, 31, 1-5.
Hansen, M.C., Flores, D.V., Coverdale, J., y Burnett, J. (2016). Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability. Journal of Elder Abuse & Neglect, 28, 41-56. doi: 10.1080/08946566.2015.1136252
Hei, A., y Dong, X. (2017). Association between neighborhood cohesion and self-neglect in Chinese-American older adults. Journal of The American Geriatrics Society, 65, 2720-2726. doi: 10.1111/jgs.15147
Hildebrand, C., Taylor, M., y Bradway, C. (2014). Elder self-neglect: The failure of coping because of cognitive and functional impairments. Journal of The American Association of Nurse Practitioners, 26, 452-462. doi: 10.1002/2327-6924.12045
Lauder, W., y Roxburgh, M. (2012). Self-neglect consultation rates and comorbidities in primary care. International Journal of Nursing Practice, 18(5), 454–461. doi: 10.1111/j.1440-172X.2012.02065.x
Lee, J. L., Burnett, J., y Dyer, C. B. (2016). Frailty in self-neglecting older adults: A secondary analysis. Journal of Elder Abuse & Neglect, 28(3), 152-162. doi: 10.1080/08946566.2016.1185986
Lee, M., y Kim, K. (2014). Prevalence and risk factors for self-neglect among older adults living alone in South Korea. International Journal of Ageing and Human Development, 78, 115–131. doi: 10.2190/AG.78.2.b
Lien, C., Rosen, T., Bloemen, E. M., Abrams, R. C., Pavlou, M., y Lachs, M. S. (2016). Narratives of self-neglect: Patterns of traumatic personal experiences and maladaptive behaviors in cognitively intact older adults. Journal of The American Geriatrics Society, 64, e195-e200. doi: 10.1111/jgs.14524
Nathanson, J.N. (2009). Animal hoarding: Slipping into the darkness of comorbid animal and self-neglect. Journal of Elder Abuse & Neglect, 21, 307-324. doi: 10.1080/08946560903004839
National Center on Elder Abuse (2018). Types of abuse. Recuperado de https://ncea.acl.gov/faq/abusetypes.html
O"Brien, J. G., Cooney, C., Bartley, M., y O"Neill, D. (2013). Self-neglect: A survey of old age psychiatrists in Ireland. International Psychogeriatrics, 25, 2088-2090. doi: 10.1017/S1041610213000999
Organización Mundial de la Salud (2002). Declaración de Toronto para la prevención global del maltrato de las personas mayores. Ginebra: Autor.
Organización Mundial de la Salud (2018): Temas de salud. Envejecimiento. Recuperado de http://www.who.int/topics/ageing/es/
Pavlou, M.P., y Lachs M.S. (2006). Could self-neglect in older geriatric subjects be a geriatric syndrome? Journal of the American Geriatrics Society, 54, 831–842. doi: 10.1111/j.1532-5415.2006.00661.x
Pavlou, M.P., y Lachs, M.S (2008). Self-neglect in older adults: A primer for clinicians. Journal of General Internal Medicine, 23, 1841–1846. doi: 10.1007/s11606-008-0717-7
Rathbone-McCuan, E. (2014). An improved approach to treating elder self-neglect: The self-care Framework. Generations, 38, 80-85.
Roane, D. M., Landers, A., Sherratt, J., y Wilson, G. S. (2017). Hoarding in the elderly: A critical review of the recent literature. International Psychogeriatrics, 29(7), 1077-1084. doi: 10.1017/S1041610216002465
Turner, A., Hochschild, A., Burnett, J., Zulfiqar, A., y Dyer, C.B. (2012). High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect. Drugs & Aging, 29, 741-749. doi: 10.1007/s40266-012-0007-2
Wand, A. F., Peisah, C., Draper, B., y Brodaty, H. (2018). Understanding self-harm in older people: a systematic review of qualitative studies. Aging & Mental Health, 22, 289-298. doi: 10.1080/13607863.2017.1304522
Watson, S. (2014). HIV and the adult at risk: a safeguarding issue. HIV Nursing, 14, 20-24.
Wilkins, S. S., Horning, S., Castle, S., Leff, A., Hahn, T. J., y Chodosh, J. (2014). Challenges and management of self-neglect in older adults with cognitive impairment. Annals of Long Term Care, 22, 30-34.
Braye, S., Orr, D., y Preston-Shoot, M. (2015a). Learning lessons about self-neglect? An analysis of serious case reviews. Journal of Adult Protection, 17, 3-18. doi: 10.1108/JAP-05-2014-0014
Braye, S., Orr, D., y Preston-Shoot, M. (2015b). Self-neglect policy and practice: research messages for practitioners. London: Social Care Institute for Excellence.
Braye, S., Orr, D., y Preston-Shoot, M. (2015c). Serious case review findings on the challenges of self-neglect: indicators for good practice. Journal of Adult Protection, 17, 75-87. doi: 10.1108/JAP-05-2014-0015
Braye, S., Orr, D., y Preston-Shoot, M. (2017). Autonomy and protection in self-neglect work: The ethical complexity of decision-making. Ethics And Social Welfare, 11, 320-335. doi: 10.1080/17496535.2017.1290814
Burnett, J., Dyer, C. B., Halphen, J. M., Achenbaum, W. A., Green, C. E., Booker, J. G., y Diamond, P. M. (2014). Four subtypes of self-neglect in older adults: Results of a latent class analysis. Journal of the American Geriatrics Society, 62, 1127-1132. doi: 10.1111/jgs.12832
Causapié, P., Balbotín, A., Porras, M., y Mateo, A. (Dirs.) (2011). Envejecimiento activo. Libro Blanco. Madrid: Ministerio de Sanidad, Política Social e Igualdad, Secretaría General de Política Social y Consumo e Instituto de Mayores y Servicios Sociales (IMSERSO).
Day, M. R., Mulcahy, H., y Leahy-Warren, P. (2016). Prevalence of self-neglect on public health nurses caseloads. British Journal of Community Nursing, 21, 31-35. doi: 10.12968/bjcn.2016.21.1.31
Day, M.R., Mulcahy, H., Leahy-Warren, P., y Downey, J. (2015). Self-neglect: A case study and implications for clinical practice. British Journal of Community Nursing, 20, 110-115. doi: 10.12968/bjcn.2015.20.3.110
Dong, X. (2014). Self-Neglect in an elderly community-dwelling U.S. Chinese population: Findings from the population study of Chinese Elderly in Chicago Study. Journal of The American Geriatrics Society, 62, 2391-2397. doi: 10.1111/jgs.13140
Dong, X. (2016). Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population. Archives of Gerontology and Geriatrics, 64, 82–89. doi: 10.1016/j.archger.2016.01.007
Dong, X. (2017). Elder self-neglect: Research and practice. Clinical Interventions in Aging, 12, 949–954. doi: 10.2147/CIA.S103359
Dong, X., y Simon, M. (2013). Association between elder self-neglect and hospice utilization in a community population. Archives of Gerontology & Geriatrics, 56, 192-198. doi: 10.1016/j.archger.2012.06.008
Dong, X., y Simon, M. (2016). Prevalence of elder self-neglect in a Chicago Chinese population: The role of cognitive physical and mental health. Geriatrics & Gerontology International, 16, 1051-1062. doi: 10.1111/ggi.12598
Dong, X., Simon, M.A, y Evans, D. (2012). Elder self-neglect and hospitalization: Findings from the Chicago Health and Aging Project. Journal of the American Geriatrics Society, 60, 202–209. doi: 10.1111/j.1532-5415.2011.03821.x
Dyer, C.B., Goodwin, J.S., Pickens-Pace, S., Burnett, J., y Kelly, P.A. (2007). Self-neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team. American Journal of Public Health, 97, 1671-1676. doi: 10.2105/AJPH.2006.097113
Dyer, C.B., Kelly, A., Pavlik, V.N., Lee, J., Doody, R.S., Regev … Smith, S.M. (2006). The making of a Self-Neglect Severity Scale. Journal of Elder Abuse & Neglect, 18, 13-23. doi: 10.1300/J084v18n04_03
Gibbons, S., Lauder, W., y Ludwick, R. (2006). Self-neglect: A proposed new NANDA diagnosis. International Journal of Nursing Terminologies and Classifications, 17, 10-18. doi: 10.1111/j.1744-618X.2006.00018.x
Halphen, J.M., y Burnett, J. (2014). Elder abuse and neglect: Appearances can be deceptive. Psychiatric Times, 31, 1-5.
Hansen, M.C., Flores, D.V., Coverdale, J., y Burnett, J. (2016). Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability. Journal of Elder Abuse & Neglect, 28, 41-56. doi: 10.1080/08946566.2015.1136252
Hei, A., y Dong, X. (2017). Association between neighborhood cohesion and self-neglect in Chinese-American older adults. Journal of The American Geriatrics Society, 65, 2720-2726. doi: 10.1111/jgs.15147
Hildebrand, C., Taylor, M., y Bradway, C. (2014). Elder self-neglect: The failure of coping because of cognitive and functional impairments. Journal of The American Association of Nurse Practitioners, 26, 452-462. doi: 10.1002/2327-6924.12045
Lauder, W., y Roxburgh, M. (2012). Self-neglect consultation rates and comorbidities in primary care. International Journal of Nursing Practice, 18(5), 454–461. doi: 10.1111/j.1440-172X.2012.02065.x
Lee, J. L., Burnett, J., y Dyer, C. B. (2016). Frailty in self-neglecting older adults: A secondary analysis. Journal of Elder Abuse & Neglect, 28(3), 152-162. doi: 10.1080/08946566.2016.1185986
Lee, M., y Kim, K. (2014). Prevalence and risk factors for self-neglect among older adults living alone in South Korea. International Journal of Ageing and Human Development, 78, 115–131. doi: 10.2190/AG.78.2.b
Lien, C., Rosen, T., Bloemen, E. M., Abrams, R. C., Pavlou, M., y Lachs, M. S. (2016). Narratives of self-neglect: Patterns of traumatic personal experiences and maladaptive behaviors in cognitively intact older adults. Journal of The American Geriatrics Society, 64, e195-e200. doi: 10.1111/jgs.14524
Nathanson, J.N. (2009). Animal hoarding: Slipping into the darkness of comorbid animal and self-neglect. Journal of Elder Abuse & Neglect, 21, 307-324. doi: 10.1080/08946560903004839
National Center on Elder Abuse (2018). Types of abuse. Recuperado de https://ncea.acl.gov/faq/abusetypes.html
O"Brien, J. G., Cooney, C., Bartley, M., y O"Neill, D. (2013). Self-neglect: A survey of old age psychiatrists in Ireland. International Psychogeriatrics, 25, 2088-2090. doi: 10.1017/S1041610213000999
Organización Mundial de la Salud (2002). Declaración de Toronto para la prevención global del maltrato de las personas mayores. Ginebra: Autor.
Organización Mundial de la Salud (2018): Temas de salud. Envejecimiento. Recuperado de http://www.who.int/topics/ageing/es/
Pavlou, M.P., y Lachs M.S. (2006). Could self-neglect in older geriatric subjects be a geriatric syndrome? Journal of the American Geriatrics Society, 54, 831–842. doi: 10.1111/j.1532-5415.2006.00661.x
Pavlou, M.P., y Lachs, M.S (2008). Self-neglect in older adults: A primer for clinicians. Journal of General Internal Medicine, 23, 1841–1846. doi: 10.1007/s11606-008-0717-7
Rathbone-McCuan, E. (2014). An improved approach to treating elder self-neglect: The self-care Framework. Generations, 38, 80-85.
Roane, D. M., Landers, A., Sherratt, J., y Wilson, G. S. (2017). Hoarding in the elderly: A critical review of the recent literature. International Psychogeriatrics, 29(7), 1077-1084. doi: 10.1017/S1041610216002465
Turner, A., Hochschild, A., Burnett, J., Zulfiqar, A., y Dyer, C.B. (2012). High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect. Drugs & Aging, 29, 741-749. doi: 10.1007/s40266-012-0007-2
Wand, A. F., Peisah, C., Draper, B., y Brodaty, H. (2018). Understanding self-harm in older people: a systematic review of qualitative studies. Aging & Mental Health, 22, 289-298. doi: 10.1080/13607863.2017.1304522
Watson, S. (2014). HIV and the adult at risk: a safeguarding issue. HIV Nursing, 14, 20-24.
Wilkins, S. S., Horning, S., Castle, S., Leff, A., Hahn, T. J., y Chodosh, J. (2014). Challenges and management of self-neglect in older adults with cognitive impairment. Annals of Long Term Care, 22, 30-34.
