Perspectives and experiences of living with self-neglect among older adults: A systematic review and meta-synthesis.

ABSTRACT

PURPOSE: Given the global trajectory toward an aging population, renewed interest in the phenomena of self-neglect is needed if relevant stakeholders are to be adequately prepared for an expected increase in the number of elder self-neglect cases. This current study is designed to systematically review and synthesize the qualitative literature on the perspectives and experiences of older adults living with self-neglect. DESIGN: A narrative meta-synthesis was used. METHODS: Six English databases (PubMed, Web of Science, CINAHL Plus, Scopus, Embase, and PsycINFO) were comprehensively searched from inception to May 2022. The thematic synthesis method was applied to analyze and synthesize the findings of the included studies. The Critical Appraisal Skills Programme qualitative checklist was applied to evaluate the quality of the included studies. FINDINGS: A total of six qualitative studies were finally included with four studies conducted in the United States, one in Israel, and one in Ireland. Through meta-synthesis, five analytical themes were identified attributes of self-neglect, life shaped by misery, insufficient social networks and resources, self-protection and preservation, and anchoring beliefs and practices. CONCLUSIONS: This qualitative synthesis provides profound insights into the self-neglect phenomenon from the standpoint of older adults with self-neglect and can provide guidance to relevant stakeholders on how to address elder self-neglect cases with respect to its assessment, reporting and management. Future research across geographical locations on the experiences of older adults with self-neglect are needed to provide a more global understanding of this significant and emerging public health issue. CLINICAL RELEVANCE The development of future self-neglect management practices based on medical and sociocultural models of care can focus on supporting self-neglecters with positive coping mechanisms and supporting service providers with spiritual care competencies to ensure interventions achieve ethical principles of autonomy, beneficence, and nonmaleficence.