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This book will help readers to better understand and address a strange social phenomenon: the apparent choice by some seniors to live in squalor.Seniors and Squalor examines the widespread and growing phenomenon of mentally competent senior citizens living in self-imposed squalor and refusing help, whether from health care professionals, government, or family. At this juncture of medicine and law, many families have experienced frustration, embarrassment, and heartbreak. The book also explores associated ethical questions, arguing that society can address the problem while respecting individual legal autonomy.For the theorist, this work provides the first in-depth treatment of legal and political theory questions undergirding the issue of self-neglect by seniors. It also underscores the importance of limited government, the necessity of granting American citizens their individual rights, and the critical need to stop classifying self-neglect as abuse.This is an ideal read for graduate and undergraduate students, scholars, practitioners of health care and geriatrics, social workers, and lawyers. Most importantly, this book will appeal to those directly affected by the problem—family, friends, and social work professionals—by giving them a broader understanding of this complex social issue and how to best respond to it.
Lisa Johnson, PhD, JD, is professor at the University of Puget Sound School of Business and Leadership, where she teaches courses in law and legal studies.
Chapter 1This Strange PhenomenonThe As Yet Unpinned SubjectTo What Extent Are We Willing to Allow Parentalist Stances by Our Government into Our Lives?Should Reason, and Our Fealty to It, Blind Us to the Human Position of "Unreason"?Should "Undesirables" Be "Dealt with" through Law?Mentally Competent Seniors Who Are Perceived to Self-Neglect: A CompositeScopeWhy Should We Focus on Mentally Competent Seniors Who Are Perceived to Self-Neglect?The Approach: Descriptive with an Excusing ConditionChapter 2Fuzzy BordersIncompetency as Political ProblemFissures in Rules and ReasonCompetence, Capacity, Self-Neglect, Elder Abuse, and SeniorsMental CompetenceCapacitySelf-Neglect and Elder AbuseSeniorsConfusion on the Front LinesChapter 3Values of the Body PoliticThe Right to Be Let AloneAutonomy as a Check against Unwanted Reach of the StateOK, Political Values Are Important, but There Is Still a Problem with My Parent (or Neighbor, or . . .)Chapter 4What Can Be Done?Perpetrators and VictimsSometimes It's Not Who They Are or What They Are, but Where They AreDo They Live Alone?Interior or Exterior?Housing DensityLegal Interests in ResidenceFrom Whence Do the Possibilities Arise?State GovernmentsFederal GovernmentLegal Theories That Might Apply, Given the Right Set of FactsActions against the Mentally Competent Senior Who Is Perceived to Self-NeglectActions against Someone ElseChoices Are ThinChapter 5What Should Be Done?Undesirables, and Law as "the Great Mucilage"General Policy PrinciplesPolicy ConsiderationsWhat Does Not WorkWhat Might WorkNotesBibliographyIndex