Self-neglect

Self-neglect

Domain 4. Activity-rest
Class 5. Self-care
Diagnostic Code: 00193
Nanda label: Self-neglect
Diagnostic focus: Self-neglect

Introduction To Nursing Diagnosis Self-Neglect

Self-neglect is a term used to describe the condition in which an individual neglects their own healthcare needs, hygiene, nutrition, safety, and environment. It may be caused by various mental, physical, or lifestyle issues, including depression, dementia, and substance abuse. Self-neglect can lead to long-term health complications and an increased risk of mortality. As such, it is essential that nurses identify self-neglect in order to provide effective and necessary interventions, leading to improved health outcomes.

NANDA Nursing Diagnosis Definition

NANDA stands for North American Nursing Diagnosis Association and is an international organization of nurses dedicated to developing, refining, and promoting standardized nursing diagnoses. With regards to self-neglect, the NANDA International Organization defines it as: “A pattern of neglecting personal care, safety, nutrition, and home management as demonstrated by fluctuations in mood and level of awareness, cognitive impairment, lack of resources, cultural background, or psychological and physical functioning”.

Defining Characteristics List

The following are defining characteristics for self-neglect:

  • Subjectives:– Reports of feeling overwhelmed or negative views of self; difficulty understanding and making decisions; feeling apathetic and not engaging in everyday activities; social isolation; poor hygiene habits; frequent unsafe behaviors.
  • Objectives:– Maintaining an unhealthy home; inability to meet basic financial or housing obligations; inadequate personal hygiene; disorientation to time and place; malnutrition or dehydration; long-term weight loss; falls; wandering.

Related Factors

There are several factors that influence the development of self-neglect, such as mental health issues, impaired physical health, intellectual disabilities, environment, demography, socio-economic status, culture, or social support networks.

Mental health issues, such as dementia, depression, or substance abuse, are the most common causes of self-neglect. Dementia, for instance, affects an individual’s ability to remember and make decisions which can lead to them not caring for themselves. Conversely, depression can cause someone to be too overwhelmed to perform everyday tasks or to even get out of bed. Substance abuse can lead to an individual not having the mental strength or clarity to properly care for themselves.

Impaired physical health can also be a factor in self-neglect. Conditions such as cancer, chronic pain, stroke, or disability can prevent an individual from being able to care for themselves. Additionally, conditions such as arthritis or vision problems might make it more difficult for them to do everyday tasks.

Intellectual disabilities, including developmental disabilities or learning disabilities, can make it harder for an individual to recall information or comprehend directions. Environment is also a factor, as an individual living in unsafe or unsupportive circumstances, such as poverty or homelessness, may lack the resources to adequately care for themselves. Furthermore, some cultures view self-care differently than western culture which could impact how an individual values and practices self-care.

Lastly, social support networks can also play a role. Individuals who lack an emotional or financial support system, may not have anyone to help with or encourage self-care.

Associated Conditions

Self-neglect can lead to a variety of mental health conditions, physical health problems, and increased risk of mortality. Mentally, self-neglect can lead to feelings of depression, anxiety, or guilt. Physically, it could result in malnutrition, dehydration, or deterioration of overall health. Additionally, it can put an individual at an increased risk of mortality due to unprotected living environments, unintentional injury, or medical problems caused by malnutrition, dehydration, or falls.

Suggestions of Use

When working with individuals who may be self-neglecting, it is important for nurses to accurately assess and identify the condition. Nurses can then develop an appropriate plan of care to address the primary needs of the individual. Additionally, nurses should evaluate the environment and offer resources to improve the individual’s situation, such as community programs, shelter, financial assistance, and other supportive services.

Nurses should also educate and reinforce healthy lifestyle habits. This includes instructing the individual on proper nutrition, exercise, and other self-care techniques. The nurse must also recognize the individual’s capacity for change and autonomy and eliminate any potential barriers preventing the individual from caring for themselves, such as access to medical care, transportation, or medication.

Suggested Alternative NANDA Nursing Diagnoses

In addition to self-neglect, the alternative NANDA nursing diagnoses that can be used to identify the condition include:

  • Disturbed Sleep Pattern: An individual who is self-neglecting can experience difficulty sleeping which can be caused by mental health distress, self-medicating, or unsafe living situations.
  • Hopelessness: An individual with self-neglect can feel hopeless due to the lack of motivation to engage in lifesaving activities such as seeking healthcare, proper nutrition, and other essentials.
  • Risk for Imbalanced Nutrition: An individual who does not take part in meal planning, grocery shopping, or utilizing food assistance programs is likely to be malnourished.

Usage Tips

When identifying self-neglect, nurses should carefully assess each individual’s unique situation. Nurses must assess the risk factors and associated conditions, while also considering the individual’s cultural background, age, and gender when crafting a plan of care. Additionally, nurses must exhibit sensitivity and respect when communicating with a self-neglecting individual and should ensure privacy, confidentiality, and a safe space when possible.

NOC Outcomes

The following NOC (Nursing Outcomes Classification) will serve to guide the assessment and evaluation of individuals experiencing self-neglect.

  • Activities of Daily Living: This outcome measures an individual’s ability to independently care for themselves and their environment, such as preparing meals, grooming, dressing, and using the bathroom.
  • Social Interaction Skills: This outcome assesses an individual’s ability to interact positively with peers, family, and friends and deal with difficult social situations.
  • Nutrition: This outcome focuses on an individual’s ability to obtain, prepare, store, and consume healthy foods for adequate nutritional intake.

Evaluation Objectives & Criteria

When evaluating a patient for self-neglect, the goal is to assess their level of care and identify any increased risks. The objectives should cover physical and mental health, home environment, and risk factors. The criteria consider the following: comprehension of instructions; proper nutrition; ability to complete activities of daily living; participation in recreational activities; demonstration of safety awareness in the home; reported mental health conditions; and presence of a support network.

NIC Interventions

For individuals experiencing self-neglect, the following NANDA interventions have been identified as helpful:

  • Adult Health Monitoring: This intervention will help medical staff monitor an individual’s physical health
  • Case Management: This intervention helps coordinate the delivery of healthcare and social services
  • Environmental Management: This intervention helps identify and address any risks within the home environment
  • Health Education: This intervention helps to educate an individual on basic health and nutrition, lifestyle habits, and disease prevention.
  • Prescriptive Therapy: This intervention may help to stabilize an individual’s mental health through counseling, therapy, or medications.
  • Supportive Therapy: This intervention helps provide emotional and educational support to individuals who are self-neglecting by providing guidance and a safe environment for expressing emotions.

Nursing Activities

Nursing activities for individuals experiencing self-neglect should involve assessing an individual’s medical, mental, and social needs, as well as providing education on disease management and self-care. Additionally, nurses should provide referrals, coordinate clinical services, provide follow-up care, and ensure that a safe environment is available to the individual.

Conclusion

Self-neglect is a significant problem that can result in many physical and mental health concerns, as well as an increase in mortality risk. Accurately identifying the condition and providing supportive interventions is essential to helping improve health outcomes. Nurses should assess the individual’s medical and psychological needs, provide education on self-care, evaluate the environment, and coordinate any necessary services.

5 Frequently Asked Questions

  • What is self-neglect?
  • Self-neglect is a condition in which an individual neglects their own healthcare needs, hygiene, nutrition, safety, and environment. It can be caused by various mental, physical, or lifestyle issues.

  • What are the consequences of self-neglect?
  • Self-neglect can lead to long-term health complications and an increased risk of mortality.

  • Are there any alternatives to self-neglect?
  • Yes, alternative NANDA nursing diagnoses that can be used to identify the condition include Disturbed Sleep Pattern, Hopelessness, and Risk for Imbalanced Nutrition.

  • How should nurses address self-neglect?
  • When working with individuals who may be self-neglecting, it is important for nurses to accurately assess and identify the condition. Nurses can then develop a plan of care to address the primary needs of the individual, offer resources to improve their situation, educate and reinforce healthy lifestyle habits, and recognize the individual’s capacity for change.

  • What nursing interventions are helpful for self-neglect?
  • Nursing interventions for self-neglect should involve assessing an individual’s medical, mental, and social needs, providing education on self-care, and coordinating any necessary services. Examples of helpful interventions include Adult Health Monitoring, Case Management, Environmental Management, Health Education, Prescriptive Therapy, and Supportive Therapy.

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