The Quiet Menace

In the Houston area, more than 60 percent of 1,500 cases handled each month by Adult Protective Services deal with elderly people who no longer can protect and provide for themselves, APS officials said.

People tend to dismiss odd behavior in the elderly as eccentricity, or they don't want to get involved in someone else's affairs, experts say. But self-neglect is likely to increase as baby boomers grow older, they say, making intervention and prevention more important than ever.

"We're trying to educate the public and people dealing with the elderly about the services available to them," said James Booker, director of Region 6 of APS, which oversees Harris County and 12 surrounding counties.

Focus of TEAM
In many self-neglect situations, the person just needs a little help to stay independent, Booker said. Most of the clients are women and most live alone, he said.

Self-neglect can be physical, medical or both. Some elderly people can't cook, clean house or bathe themselves. Some don't eat properly; some lack running water or air-conditioning. Their houses might be filthy and in disrepair.

Others lack access to medical care. They may have stopped taking their medicine or they haven't seen a doctor in years and they've developed a serious illness, such as cancer or diabetes.

The breakdown in their ability to plan and carry out tasks can be caused by issues such as a stroke, dementia or depression, according to researchers.

To address self-neglect, Region 6 has collaborated with the University of Texas Health Science Center at Houston and Baylor College of Medicine for the past 15 years. The partnership is called the Texas Elder Abuse and Mistreatment Institute, or TEAM, which consists of clinical care, education and research. Region 6 is the only APS agency in the state to use such a multidisciplinary approach.

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The Quiet Menace