Self-Neglect

Abstract

<p>Self-neglect is a condition peculiar to the frail geriatric population when a self-conscious individual voluntarily refuse to address one’s basic physical, emotional or social need. The end result is a constellation of findings bearing similarity to physical abuse and neglect. There may be injuries including bruising and fractures, signs of dehydration and malnutrition, presence of decubitus ulcers, poor hygiene in the context of unsanitary living conditions. Underlying psychiatric conditions affecting decision making capacity may be implicated. Normal aging process of organ systems and increased geriatric comorbidities render them vulnerable to accidental injuries and delayed management of treatable medical conditions in an isolated home environment. During medicolegal investigation, it is essential to identify features that differentiate from genuine elder maltreatment. Diogenes Syndrome is an extreme form of fatal self-neglect for individuals in social isolation with hoarding of rubbish or household items. This presents considerable forensic difficulties because of the mysterious circumstances, a lack of medical history, suspicious findings on the body including purging of putrefactive fluids and injuries following falls or post-mortem animal predation in a chaotic scene.<br></p>