Elder Self-Neglect - How Can a Physician Help?
New England Journal of Medicine (Impact Factor: 55.87). 12/2013; 369(26):2476-9. DOI: 10.1056/NEJMp1310684
Clinicians often expend considerable effort caring for elderly patients who neglect their own needs. But there are some practical approaches to the clinical care of self-neglecting patients. Mr. L. is a 96-year-old widower with critical aortic stenosis and mild cognitive impairment who had become increasingly short of breath and exhausted over the course of several weeks and needed 3 hours to get dressed on the day of admission. A concerned neighbor brought him to the hospital. He is not a candidate for aortic-valve replacement owing to poor functional status and coexisting conditions, and after several days of gentle diuresis, he can barely walk across the room. At the request of the primary care physician, Mr. L.'s son flies in for a family meeting to discuss discharge options. ...
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