LAUSR

Background: Self-neglect is defined as the inability or unwillingness to provide oneself with necessary resources to maintain safety and health. Severe alcohol abuse is classified as alcohol use disorder (AUD) under DSM–5. Self-neglect and alcohol use disorder are growing issues worldwide and are often unrecognised and unreported. They are linked to significant public health issues, including psychological distress, chronic disease, and death. These will put increased pressure on health and social care services as population’s age. Methods: A comprehensive literature search was conducted using EBSCO, Embase, Medline PsychINFO and CINAHL to identify articles on alcohol abuse and older people’s self-neglect published between 2000 and 2017. Grey literature was also accessed. Reference lists of all included articles were reviewed. The key words included in the search were: ‘selfneglect’, ‘abuse’, ‘alcohol misuse’, ‘alcohol use disorder’ and ‘older people’. Results: The search yielded 38 articles. Thirteen studies were included in review. Studies were descriptive, case series, secondary data analysis mixed methods and cross-sectional. Several narrated and described struggles with alcoholism. Only three studies used measures to screen for alcohol abuse. There was no prevalence data for alcohol-related selfneglect. Older self-neglecting adults who misuse alcohol, have significantly higher depression. Alcohol misuse is predictive of higher recidivism to Adult Protective Services (APS). Understanding self-neglect and alcohol misuse within a life course perspective (e.g. family systems, childhood trauma, social isolation and loneliness) is important. Practitioners challenged by cases where alcohol misuse had led to self-neglect. Conclusions: Severity of self-neglect is heightened when older adults misuse alcohol and safeguarding is more complex. Alcohol misuse is a risk factor for self-neglect yet little research has measured alcohol abuse and severity of self-neglect among self-neglecting older adults. The causal connections between self-neglect, alcohol abuse and depression needs to be further explored.