Feasibility of intervention in elder self-neglecters: Setting the stage for future research

ABSTRACT

Objectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.

Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.

Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).

Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.

KEYWORDS:

• Clinical trial
• elder mistreatment
• randomized controlled trial
• self-neglect

Acknowledgments

We thank the participants for taking part in this clinical trial, as well as Texas Adult Protective Services for providing us with access to their caseworkers and clients. We would also like to thank the NASA Nutritional Biochemistry Laboratory for their support of the sample analyses. J. Krauhs, an employee of KBRwyle, contracted with NASA, copyedited the manuscript before submission.

Conflicts of interest

The authors have no financial or personal conflicts.

Additional information

Funding

This work was supported by the National Institute on Aging at the National Institutes of Health: [Grant Number R21 AG033261], for the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.