When an elderly individual starts to manifest obvious signs of extreme self-neglect or lack of care for their surroundings — this may be the onset of Diogenes Syndrome. This behavioral disorder affects the elderly and is characterized by the lack of shame living in unsanitary conditions and poor hygiene. Most often they may not even have any sign of mental impairment that can explain their condition.
Diogenes Syndrome was named after an ancient Greek philosopher Diogenes of Sinope from the 4th century who was famous for living inside a barrel. Diogenes at that time showed a lack of shame with the way he lived and had no regard for any social associations. He was said to have lived his days begging and lived out his days in social isolation. Readings mentioned how Alexander the Great came to Diogenes as Diogenes was the only person who could not be bothered to pay him his respects. Alexander the Great found him lying on the ground under the sun and asked if there was anything he could offer to help. Diogenes looked up and with squinting eyes and asked to move because he was blocking the sunlight from him
Diogenes syndrome can be closely related to Dementia. However, health workers involved with senior adult care have many cases to date that show no cause of psychiatric disorder from these older adult individuals.
The exact cause of this disorder is not quite on the clear but it is linked to neurologic and psycho-emotional factors.
What Is Diogenes Syndrome?
Both men and women can be affected by Diogenes Syndrome. No matter the socioeconomic status but very much pronounced in older people. The disorder shows no real correlation with the level of intelligence of affected seniors and their genders. However, studies show that it is common for people who are over 60 and those who live alone. It is considered a rare condition as only 0.05 % of seniors aged 60 and older may be affected.
Diogenes syndrome can either be a primary or secondary affliction, and the latter may be a result of another mental disorder. It is also known as a senile or severe social breakdown, senile squalor syndrome, self-neglect syndrome or the messy house syndrome.
The incidence of Diogenes syndrome has been pegged at 5 for every 10,000 adults 60 yrs old and above. It is has been closely related to a form of hoarding disorder but not necessarily a real hoarding disorder because there is an abnormal clustering of stuff that doesn’t have any real value or sentimental worth to the individual.
This state of unexplained clutter is also taken to an extreme by the affected individual as their homes become unsanitary and described as living in squalor.
Symptoms of Diogenes Syndrome
Age plays a big factor in this disorder. Some studies link the sudden onset of Diogenes in the elderly when they are diagnosed with a life-threatening illness such as cancer and those who are living alone. There have been cases where the person returns to their usual self upon treatment of whatever illness they have. Most patients do not display any symptoms of psychosis either. But despite the clutter and lack of hygiene they lack insight into their living situation and do not display any distress with their living conditions. at all. Cases have been reported where individuals hoard spoiled/ rotting food, garbage, and even human waste in their homes.
Apart from living in squalor and extreme self-neglect — the affected individual typically will not ask for any help.
People with Diogenes syndrome may also develop certain skin issues like dermatitis. This is usually characterized by a horny and crusty layer of skin that develops due to a lack of skin washing or bathing. Poor oral hygiene is also present and often leads to dental rot and halitosis.
The problem with this behavioral disorder is that it can be difficult to tell from other medical conditions as they all have very similar symptoms with these other disorders:
- Frontotemporal dementia
- Alcohol abuse
- Obsessive-compulsive disorder
The symptoms may vary for every individual depending on the individual, however, studies show that extreme self-neglect with nutritional deficiencies are seen in patients who have had a successful career in their past and have had a high intelligence quotient.
Below is a list of symptoms that can begin to slowly manifest one by one or suddenly appear in a cluster at the same time.
- Poor understanding of self-hygiene and public health
- Lacking safety insight
- Extreme anxiety
- Obsessive-compulsive behavior
- Unsanitary living conditions
- Detachment from others even loved ones
- Skin issues due to poor hygiene
- Hoarding of non-valuable items including human waste
- Distrust of medical professionals
- Unwillingness to accept help
- Social anxiety
- Wary of other people
- Poor health due to bad nutrition and diet