Monthly Archives: October 2012

Self-neglect-Looking through the eyes of abuse


Carolyn Coleman-Grady, RN, BSN

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The health care industry cares about the elderly population. To ensure that the health and wellbeing of this aggregate group remain the focus of families and health care providers education on elder abuse is pivotal. It is important that families are equipped to meet the challenges of elderly abuse recognizing elder abuse is the first step. People are living longer and health challenges are challenges increasing.  The health care industry is concerned about Self-neglect. Experts suggest that cognitive deficits (changes) contribute to this problem (Kelly, Camel, Dyer, Pavlik, Doody & Jogert (2008). Taking care of our elderly is important. The question becomes how do we distinguish between non-self-neglect and self-neglect.

A team of experts developed indicators that help determine the differences.

Common signs of elder self-neglect include:

  1. Little or no personal care: poor grooming, dirty or ragged clothes, unclean skin and fingernails
  2. Refusing medication or refusing to stay on medication schedule, unwilling to accept medical care
  3. Disoriented or incoherent: unable to focus, carry on normal conversation or answer basic questions about date, place, and time
  4. Unsafe living conditions: Lack of food or basic utilities in the home, unclean living quarters, rodents or other vermin
  5. Hoarding animals or trash, inability to get rid of unneeded items
  6. Inability to manage finances and property: not paying bills, repeatedly borrows money, gives money or property away
  7. Isolation:: Little contact with family or friends, no social support
  8. Alcohol or drug dependence

It is important to know these indicators. These indicators will help you make better decision. Some decisions may include relocating from home to an assisted living facility, board and care or into your home. To determine the best decision, I suggest you visit facilities, speak with the administrators, activity directors and lead staff members. I can share with you if there is an odor of urine leave.  Patients that are not clean dressed and/or hair is not combed leave the facility.

Remember self-neglect can happen to anyone experts suggest that cognitive changes are contributing factors. Make wise decision when you identify the above indicators. Developing a plan for your elderly family members will help decrease self-neglect. If possible stay connected to your elderly family members, listen patiently and implement an effective plan it will reduce the effects of self-neglect.


Kelly, A., Dyer, C., Pavlik, V., Doody, R., & Jogerst, G. (2008). Exploring self-neglect in older adults: Preliminary findings of the self-neglect severity scale and next steps. Journal of Geriatric nursing 56(2) 254-259.

My name is Carolyn Coleman-Grady

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New beginnings: Frameworks that hold evidence




Good morning everyone here is a quote from Plato: You know that the beginning is the most important part of any work expecially in the case of a young and tender thing;for that is the tme in which the charater is being formed and the desired impression is more readily taken (Plato)

The challenge of new ideas can create and contribute to incomplete projects. The solution is in the developmental phases of your idea. Concepts fail and succeed. Deciding to develop a framework that proves solid brings growth  and sustainable which brings success. Plato suggest, ” young and tender thing that is the time in which the character is being formed and the desired impression is ore readily taken”. How to build character in business? It begins with your own beliefs about business. For example, mimicking ethical behaviors that promote honesty integrity and questioning your on beliefs are important beginning frameworks. Pierce suggest four methods in fixing your beliefs: tenacity, authority,priority and reasoning (Houser & kloesel, 1992).

Many business owners today find it difficult to exam their belief systems because it causes one to look beyond the surface. You must look deep in the core of your beliefs to determine how your beliefs developed? What internal and external forces affect your beliefs? And, if there are areas in your belief system that will affect building your business, establishing relationships and helping others become successful. The framework must come from a beginning and identifying the root will begin your new journey.

Lewis, (1942) theory of change provides reliable and valid evidence on how to begin the change process. The theory discussed three key concepts, unfreezing, change and freezing (pp.5). These three steps are the framwork of truths that hold evidence in developing change behaviors. How does one unfreeze old beliefs? Decide to exam the learned behavior, implement the change theory and reject prior learning. This is the unfreezing stage. Idenifying learned behavior must than be rejected (Lewis, 1942).

Change a small word with sudden impact and fear will introduce itself immediately to you. It is both challenging and for some painful. Lets take a car a stick shift gears are implace to make the appropriate shift while driving. Going up a hill you’ll need a gear shift. In change you must shift the way you think, feel and behave (Lewis, 1942). I spoke with a friend the other day one of the challenges shared in the conversation involved a lack of willingness to change. My friend said, “this is the way I’ve always done it,” how do you respond to thinking that challenges successful change? A reasonable person will here themselves speak, an unreasonable person will build strong blocks around there brain and heart. An unreasonable person will not hear anything. Change begins with identifying what needs to be change.

A theoretical concept that promotes truths begins with unfreezing beliefs and prior learnings implementing change process than acting on the change by a freezing process. Thank a popsicle melt it what you see is liquid place it back in the freezer and it will freeze not in the same form or shape. Freezing new way of thinking behaviors and beliefs requires unfreezing change and the refreezing. Developing new ideas, that will set you free to grow and flourish. This process is challenging but the end results are rewarding.



Lewis, K. (1942). Change theory. Retrieved from

Houser, N., & Kolesel, C., (1992). The essential pierce:selected philosphical writing(vol 1)Bloomington.Indiana University Press.

Kritsonis A. Comparison of Change Theories. International Journal of Scholarly Academic Intellectual Diversity; 8:1, 2004-2005.

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Carolyn Coleman-Grady