P23: Characteristics of older adults with domestic squalor in Japan: a cross-sectional study

Abstract

Objectives: Domestic squalor (DS) is related to physical problems, living alone, problems for their family and neighbors, and mental illness, the most common of which is dementia. Early intervention for DS is important; however, Methods to detect and treat older adults with DS remain unclear. This study aimed to clarify the Methods of early intervention in older adults with DS.

Methods: The Initial-phase Intensive Support Team for Dementia (IPIST) is a multidisciplinary outreach team that provides intensive initial assessment and support for people living at home with suspected dementia in Japan. We distributed a questionnaire to 50 IPISTs that had reported experience of dealing with many complex cases’’ in our previous nationwide survey, asking them to provide detailed information on two complex cases’’ that were extremely difficult to approach or link to medical or long-term care. The questionnaire consisted of questions regarding sociodemographic characteristics, clinical assessments, referral sources, and reasons for complexity. We compared the results of the questionnaire between cases with and without DS (DS+ vs. DS-) and between cases with DS who lived alone and those who lived with family (DS+ living alone vs. DS+ living withfamily).

Results: We received responses from 33 IPISTs and collected data from 70 complex cases. DS was selected as the reason for complexity in 24 cases. Fourteen DS+ cases lived alone. DS+ cases referred by the family (8.3%) were significantly fewer than DS- cases (54.3%). In DS+ cases, the most common referral sources were neighbors and welfare commissioners. The proportion of cases having self-neglect were significantly more in DS+ (87.5%) than in DS- (13.0%). DS+ cases living alone were significantly younger (mean ± SD; 72.9 ± 7.3) than those living with family (80.0 ± 6.7). Family members living with DS+ cases also had issues including mental illness or maltreatment.

Conclusions: This study revealed that most older adults with DS experience self-neglect and a lack of supportive family members. A comprehensive approach to both older adults with DS and their families is important for early intervention, and therefore IPISTs that have a multidisciplinary team with an outreach function would be useful.