Is pain a significant factor in elder self-neglect?
OBJECTIVE
Pain is a worldwide health concern leading to cognitive impairments, depression, and decline in activities of daily living when poorly controlled. Self-neglect is also a serious public health issue being the most common allegation reported to Adult Protective Services (APS). The purpose of this analysis is to determine whether self-reported pain is associated with validated cases of self-neglect compared with matched controls.


METHODS
This is a cross-sectional study of 80 (APS) validated cases of self-neglect aged 65 years and older and 80 control participants recruited from a geriatric clinic at Harris County Hospital District. Control participants were matched for age, race, gender, and zip code. Both groups were administered the Wong-Baker FACES rating scale and the Mini-Mental State Examination in their homes by a geriatric nurse practitioner and a research assistant.


RESULTS
Self-reported pain was noted in 43% of the self-neglect group compared with only 28% in the control group (X2 = 3.85, df = 1, p = .05). This difference became non-significant after stratifying for MMSE scores of 19 or greater (X2 = 3.38, df = 1, p = .066). The self-neglecting elderly also reported significantly higher levels of pain compared with the matched controls (t = 2.5, df = 143, p = .014). This mean difference remained significant after stratifying by MMSE scores of 19 or greater (t = 2.6, df = 124, p = .009).


CONCLUSIONS
The data provide preliminary support for the relationship between self-reported pain and elder self-neglect. Research is needed to determine whether pain is a causal or associated factor in self-neglect and whether therapeutic intervention can improve the syndrome of self-neglect.
Pickens
Sabrina
S
CREST, University of Texas Medical School--Houston, Harris County Hospital District, 77004, USA. Sabrina_Pickens@hchd.tmc.edu
Burnett
Jason
J
Naik
Aanand D
AD
Holmes
Holly M
HM
Dyer
Carmel Bitondo
CB
D000368:Aged; D003430:Cross-Sectional Studies; D004552:Elder Abuse / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012648:Self Care / Q000523:psychology*; D014481:United States / Q000453:epidemiology