Self-Neglecting Elders: A Clinical Dilemma Rathbone-McCaun E, Fabian DR (Eds). New York: Auburn House, 1 992; 1 97 pages, $42.95, hardcover.
The 197-page text consists of ten chapters written by 15 contributing authors, including the editors. Most of the authors are social workers, but contributions by a gerontologist, geropsychiatrist, and physicians emphasize the need for and the value of an interdisciplinary approach to this serious and heretofore unexplored elder care issue.
The book's major strength is its focus, elder self-neglect - a subject that has been minimally addressed in geriatric literature. This book attempts to define the concept and clarify the dilemma for professional practitioners working in the field of geriatric services. It contains numerous narrative accounts of practice-based paradigm cases presented by clinicians. These exemplars set the stage for analysis of the physiological and psychosocial dimensions of this strategic clinical and societal problem.
The format and readability of the book is an asset. The text is divided into three sections, with each section divided into chapters. Section I provides an overview of elder self-neglect. Section II looks at system considerations. For example, family systems, psychiatric and biomedical considerations, and ethical issues are all examined in this section. Section ?? includes such topics as older developmentally disabled adults; geriatric alcoholism; and geriatric protective services.
The book begins by identifying elder self-neglect as a clinical phenomenon with broad implications. The editors examine the concept by reviewing the literature and explaining the ethical dilemma of self-neglect for clinical practitioners. Some common sources of practitioner frustration in working with self-neglecting elderly persons are explored. These include issues such as personal care deficits, lack of adequate resources, environmental considerations, legal implications, and compliance with recommendations of the provider.
The final chapter of the book, "Research and Clinical Directions and SelfNeglect," identifies specific issues and questions that should be the focus of applied research and experimental programs. Recommendations for clinical knowledge development include the establishment of an epidemiological data base to enhance understanding of the distribution of self -neglect in the older population; refinements in assessment programs; and gathering information from samples of elder persons in which self-neglect occurs. The book also provides a comprehensive bibliography and index.