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The Gerontologist Advance Access published online on September 2, 2009
The Gerontologist, doi:10.1093/geront/gnp125
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

The Development of a Conceptual Model for Understanding Elder Self-Neglect

Madelyn Iris, PhD1,2, John W. Ridings, PhD3 and Kendon J. Conrad, PhD4

2 Leonard Schanfield Research Institute, CJE SeniorLife, Chicago, Illinois
3 Department of Outcomes and Evaluation, Metropolitan Family Services, Chicago, Illinois
4 Department of Health Policy and Administration, School of Public Health, University of Illinois at Chicago

1 Address correspondence to Madelyn Iris, PhD, Director, Leonard Schanfield Research Institute, CJE SeniorLife, 3003 W. Touhy, Chicago, IL 60645. E-mail: micki.iris{at}cje.net


  Abstract

Purpose: Elder self-neglect (ESN) represents half or more of all cases reported to adult protective services. ESN directly affects older adults and also their families, neighbors, and the larger communities around them. ESN has public health implications and is associated with higher than expected mortality rates, hospitalizations, long-term care placements, and localized environmental and safety hazards. This article describes results from a study using concept mapping to create a conceptual model of ESN. Design and Methods: Two brainstorming sessions were convened with senior services program supervisors, geriatricians, local policy analysts and program planners, elder law practitioners, and university-based researchers (n = 20), and a list of 73 ESN indicators was generated. Using Concept Systems software, the 20 original panelists and an additional 30 practitioners, including case managers and supervisors from local agencies, social workers specializing in working with older adults, and elder abuse investigators, sorted the 73 items and rated them along the dimension of importance for the concept of self-neglect. Results: Using hierarchical cluster analysis and multidimensional scaling, a conceptual map with 7 clusters was produced. Clusters with the highest importance ratings were Physical Living Conditions and Mental Health. Clusters were highly interrelated, with the exception of the Physical Living Conditions cluster. Implications: This research presents a conceptualization of ESN, identifies the constituent domains, and proposes a conceptual model based on the importance for assessing symptoms and indicators. Findings may help focus programmatic and research efforts, leading to the development of measures that open the field for further research and theory generation.

Keywords: Concept mapping, Self-neglect, Conceptual modeling

Received February 19, 2009; Accepted July 30, 2009

Decision Editor: Nancy Schoenberg, PhD


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