I’m Worried Someone Can’t Care for Themselves
Living alone, refusing help, keeping a cluttered home, or making choices others disagree with doesn’t by itself mean someone can’t care for themselves.
What matters is whether an essential need is going unmet, whether the person is becoming unsafe, and whether they can understand and respond to the problem.
Find Out What’s Actually Happening
Ask:
- Is the person without food, water, essential medicine, working utilities, or needed medical care?
- Can they use the bathroom, get out of bed, move around, and meet other essential needs?
- Could they get out safely in an emergency?
- Has their health, memory, judgment, or daily functioning changed?
- Do they understand what’s happening and what could happen if nothing changes?
Write down what you directly see: missed medication, lack of food, falls, untreated symptoms, unsafe conditions, or changes in memory.
Concern about what might happen isn’t the same as a current emergency.
If you can’t reach the person and are worried they may be hurt or unable to get help, call the local law-enforcement non-emergency number and ask about a welfare check. If they may be in immediate danger, call 911.
If a fall already happened, use I Need Help After a Fall →
If the question is how much time alone is safe, use Can This Person Be Left Alone? →
Find Out Which Problem This Is
Ask whether the person:
- can’t do what’s needed
- can’t afford or arrange the help
- doesn’t understand the risk
- understands the risk and doesn’t want the help being offered
Each one needs a different kind of help.
Start With the Unmet Need
Don’t try to fix everything at once.
If possible, address the immediate problem with the person’s agreement: food, medication, medical care, utilities, transportation, or another essential need.
A small amount of help may be enough.
Respect the Person’s Choices
A person may understand the risk and still refuse help or choose to live in a way you wouldn’t choose.
A choice you disagree with doesn’t, by itself, mean the person lacks capacity or is self-neglecting.
If the person understands the decision, start with the help they’re willing to accept.
Don’t remove belongings, take control of money, force a move, or make decisions for someone else before you find out what authority you have.
If Health or Ability Has Changed
Contact the health care team.
Say:
“This is what the person could do before, this is what they can’t do now, and this is the help that’s missing. What needs to happen next?”
Ask whether the person needs treatment, more help at home, equipment, supervision, hospice or palliative care, or another level of care.
Ask whether a social worker, care manager, occupational therapist, or physical therapist can assess what’s needed. Asking for a specific discipline by name gets a different answer than asking for help in general.
If hospice is involved, use the hospice 24-hour number.
If Someone Else Is Providing the Care and It Isn’t Enough
A care arrangement that used to work can stop working without anyone intending harm.
If the caregiver can no longer provide the care safely, tell the health care team what changed and ask what has to change in the plan.
If the Problem Is Practical
Sometimes the person needs practical help, not an investigation.
If the main problem is food, utilities, transportation, housing, personal care, or another practical need, start with help for that need.
Eldercare Locator can connect older adults and families with local aging services.
Local aging and community-service organizations may be able to help with meals, transportation, personal care, benefits, or other support.
If the Person May Not Be Able to Stay Safe
Consider Adult Protective Services when an essential need is going unmet and the person is becoming unsafe, especially if they may not understand or be able to respond to the risk.
You don’t need to prove self-neglect before making a report.
Ask:
“Does this situation fall under Adult Protective Services, and what happens next?”
APS screens the report first. If it meets the program’s criteria, a worker may assess what’s happening and offer or arrange help.
Calling APS doesn’t automatically mean the person will be removed from home or lose control over their decisions. Who APS serves and what it can do vary by state.
If APS says the situation isn’t theirs to handle, ask:
“Who should I contact next?”
Follow that referral.
If you think someone else may be neglecting, exploiting, threatening, or harming the person, use I Think Someone Is Being Abused, Neglected, or Exploited →
Before the Call Ends
Ask:
“Who’s responsible for the next step?”
“What should happen if this can’t be fixed today?”
“What should I do if the person becomes less safe?”
Find the essential need that isn’t being met, and start there.
Helpful Resources
Find the Adult Protective Services reporting number for your state.
Connects older adults and families with local aging services and can help identify Adult Protective Services and other community resources.
Learn More
Practical information about in-home help, personal care, meals, transportation, and other services that can help an older adult remain at home.