Neglect of those living in long-term care facilities and those living in the community is an important topic to understand. There are many forms of neglect and a wide variety of signs to look out for. This may make it very difficult to spot instances of neglect. Fortunately, there are steps that friends, family, neighbors, and caregivers can take to prevent neglect of a long-term care resident.

What is Elder Neglect?

Each state has its own specific definition of “neglect.” In Missouri, neglect happens when a caregiver – either an individual or an organization – does not provide necessary protection and services to an eligible adult.

Missouri also defines a second term, “institutional neglect,” as when a care facility does not protect and provide necessary services for a resident, resulting in the harm or potential harm of that resident.

If you’d like to read all of Missouri’s official elder abuse and neglect definitions, or compare definitions across the United States, check out this excerpt from “Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America” (2003).

How Does Neglect Happen?

There are several areas of neglect that older individuals or individuals with different abilities may experience.

Physical Neglect

This happens when the medical, hygiene, and dietary needs of an individual are not met. The basic physical needs, like healthcare, cleanliness, and nutrition, are not met.

Emotional Neglect

This happens when a caregiver ignores an individual or treats them as unimportant. It may also include treating a care receiver like a child, ignoring their capabilities and experiences. The individual’s mental health needs are not met.

Financial Neglect

This form of neglect happens if a caregiver or other representative does not care for an individual’s financial obligations. An example is not paying bills on time, creating financial challenges for the care receiver. You may want to speak with a lawyer to clarify the caregiver’s responsibility.


Abandonment occurs when a caregiver stops providing care for an individual without first finding another appropriate caregiver. In other words, a caregiver leaves their care receiver without any support.


Yes, a person can neglect him or herself. Self-neglect is a true form of elder neglect, and it should be addressed like any other kind. The United States Department of Health and Senior Services (DHSS) defines self-neglect as: “Behavior of an elderly person that threatens his/her own health or safety…” For example, a person might not consume enough food and water, maintain hygiene or safety, or take prescribed medications.

Many reports say that self-neglect might be the most common form of elder neglect. Additionally, self-neglect often happens to people living in their own homes, so it can be hard to spot. It’s hard to know how difficult self-neglect really is. Learn more about self-neglect here.

How to Spot Neglect

There are many signs that may help you identify potential neglect or self-neglect. For example, you might notice:

  • An individual losing contact with family and friends
  • Changes to physical appearance such as sudden weight loss, appearing hungry, looking disheveled, or seeming confused
  • A caregiver not arriving on time – or at all
  • Unsafe and unclean living conditions
  • An individual suddenly not being able to meet their own needs

This is not a complete list of possible signs. To read all about possible signs of neglect, visit the National Adult Protective Services Association. You can also learn more about self-neglect from AgingCare.

What Can You Do?

In an emergency, call 911. Seek immediate help in an emergency! If you see signs of abuse or neglect, talk to the caregiver about your concerns. If the caregiver is not open to talking, you should reach out to a long-term care ombudsman.

The ombudsman can help you report the neglect to your state’s Adult Protective Services (APS). Missouri residents can find their APS office here. The National APS Association also has resources listed here.

Remember, emergency and APS officials are trained to assess situations reported to them. So, if you think you see signs of neglect, act fast. Call 911, your ombudsman, or your local APS office for help.


  1. 1
    Melissa Andrews on January 4, 2021

    It just breaks my heart that elder neglect happens. As if our seniors don’t have enough problems with the COVID-19 pandemic.

  2. 2
    JOHN HOFFMAN on January 9, 2021

    My wife was admitted to Westchester HOUSE on Dec.30th. She passed away on Jan.4th of unknown cause. I question if they did much of anything for her, since I was unable to see her.

    1. 3
      lsykes on January 11, 2021

      I am so sorry to hear about your loss, John. The Regional Ombudsman Coordinator who oversees Westchester House is Katie Morrison. Her number is 314-919-2409, and her email is Please feel free to reach out to her with any questions or concerns about Westchester House.

  3. 4
    keith w kressu on February 4, 2021

    I have been caregiving for my elderly mom age 92 for the past seven years. My girlfriend has been a huge help in this regard taking care of female aspects like showering going to the bathroom etc.
    My sister who is financially irresponsible and an alcoholic has been calling my mom and manipulating her into moving in with her. My sister currently resides in NY but will be moving to Fla because she is far behind in her rent of a 5000 a month condo which my mom had to cosign for as my sister has been evicted from just about any place shes resided. My mother has bailed her out on numerous occasions with tens of thousands to keep her from being sued.
    Now my sister once again due to her living the highlife and not saving is broke again and wants my mom to move in with her. I read an article that states moving the elderly is not a good idea because elderly people need familiarity. It can cause the elderly to fail and pass away more quickly.
    I have partial power of attorney with my twin brother but he doesnt want anything to do with this matter.
    Hes leaving it up to me to guard our mother.
    The last time my sister was here she purposefully tried to create a wedge between my longtime girlfriend of 10 years by telling her untruths about me as well. She wants my girlfriend to leave me so she wont get any of my estate. I am having my mom evaluated psychologically so as to prove she is incapable and feeble to handle her own bills. She doesnt even know what day or time it is and yet my sister wants to manipulate her What can I do to stop her.

    1. 5
      lsykes on February 4, 2021

      Hello, Keith. If you suspect abuse or neglect, which includes financial abuse, you can call the Abuse and Neglect Hotline at 1-800-392-0210 or report it online here:

      Other than the Hotline, you can contact the Missouri Protection & Advocacy Services: (573) 893-3333 or 1 (800) 392-8667. Their lawyers can provide legal advice.

      Safe Connections (314-646-7500; is a good St. Louis local organization that deals with domestic violence. They have a 24/7 Crisis Helpline 314-531-2003, which is helpful.

      Our ombudsman are also available if you have any additional questions or need further assistance.

      1. 6
        lele on February 12, 2021

        Hi Keith, In Florida, your concerns will probably go unanswered as mine did. My mom passed on Christmas day, sadly. What my evil sister put us through the past 5 years will linger and have an impact for years to come.

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