Did Formal and Informal Social Supports Decrease Self-Neglect of Older Adults Living Alone in Korea?

Background and Purpose:

Most of the empirical studies on elder neglect in Korea have addressed only elder neglect by family members. Among the elder abuse cases reported by Korea’s Adult Protection Services, only 8% were categorized as self-neglect, compared with the ratio of self-neglect (>50%) in the United States. Although older adults living alone are rapidly growing (27.3% in elderly households), a few studies in Korea have examined the prevalence and risk factors of self-neglect among older adults living alone. This study was designed to test that social supports serve as resources to decrease self-neglect. We hypothesized that older persons living alone with more formal and informal social supports are less likely to do self-neglect.

Methods:

This study used a cross-sectional design with a proportionate quota sampling method. The percentage of gender (male and female), age group (60’s, 70’s, and over 80) and districts were considered to represent the current demographic characteristics of Busan. A total of 362 older adults (+60) living alone in Busan metropolitan city consented to participate face-to-face survey by trained interviewers by the researcher. The data were employed from a regional living profile of older people survey in 2015 by the Busan Social Welfare Development Institute and the first author was the primary researcher for the survey.

The dependent variable of elder self-neglect was measured by a subscale the Screening Scale for Elder Abuse (e. g., suffering from malnutrition due to intentionally eating inadequate food, failing to maintain a minimum level of hygiene and sanitation). Independent variables were formal social supports (use of senior center), informal social supports (Lubben Social Network Scale, LSNS-6). Gender, age, education level, economic status, functional abilities (ADLs, IADLs), and depressive symptoms (PHQ-9) were considered as control variables. The multiple regression analysis was conducted with SPSS 21.0 program. 

Results:

The findings of this study showed that the full model explained 42.8% of the dependentvariable, and gender (β =-.143, p <.01), age (β =-.092, p <.05), depressive symptoms (β = .642, p < =.001) and formal social supports (β =-.084, p <.05) were statistically related with risk of self-neglect. Older adults who were male and more aged, and had higher levels of depressive symptoms were likely to suffer from self-neglect. Consistent with the hypothesis, use of senior center (formal social supports) was negatively related with the severity of self-neglect. Unexpectedly, informal social supports were not statistically associated with self-neglect.

Conclusions and Implications:

This study empirically identified that formal social supports had the negative relationship with the severity of elder abuse. Social work practitioners and policy makers should be aware of the empirical result that older adults living alone with formal social supports are less likely to do self-neglect. In addition, informal social supportswere not effective to decrease self-neglect for the elderly living alone. Lastly, it is important for gerontological social workers to encourage older adults living alone in community to take part in social programs.