Pavlou and Lachs reported a number of red flags that can help to identify a patient with self-neglect. The authors are from Weill Cornell Medical College in New York City.
Red flags for self-neglect:
(1) consciously neglecting chronic medical problems
(2) unexplained lapses in recommended health maintenance activities
(3) disheveled appearance and lack of personal hygiene
(4) bodily infestation (lice, magots, etc)
(5) untreated chronic wounds
(6) long fingernails or toenails (untrimmed nails)
(7) impaired cognition
(8) discrepancies between the patient's reported ability to perform ADL AND the reports of others or current appearance
(9) refusing a needed assistive device
(10) lack of social network, especially if voluntary
(11) evidence of depression
(12) psychotic symptoms
(13) strong beliefs against a provider's recommendations, or an unwillingness to discuss
(14) substance abuse
(15) infestation of the home(insects, mice)
(16) clutter filling the home
(17) non-functioning utilities or appliances
(18) threatened eviction
(19) significant problems seen on home visit (hoarding, fire hazards, rotten food, malodors, multiple animals, etc)
