1. Elder Self Neglect: What can we learn from self- neglecting elders? Dr. Tova Band-Winterstein, Mrs. Sigal Naim, & Dr. Israel (Issi) Doron Department of Gerontology University of Haifa, Israel Acknowledgments: This study was funded by Macabbi Health Care Services Research Fund in Israel

2. Who is this?

3. What is elder ‘ self neglect ” ?  The general context of “ elder abuse and neglect ”  The general uniqueness of self neglect  The difficulties with the definition and the question of culture  Main manifestations: “ medical ” and “ ecological ”

4. The Extent of the Phenomenon  The difficulties in “ measuring ” elder abuse and neglect;  The difficulties in “ measuring ” elder self neglect and lack of evaluation tools  The different legal framework and lack of mandatory reporting;

5. The Characteristics of elder self neglect ד  Older old;  Sickness and disability  Cognitive impairments  Lower socio-economic level  Loneliness

6. The Study  Methodology in general;  The sample;  16 interviewees; 10 women and six men. Their age range was between 62 and 90 years, with mean age 73 years.  Procedure  Ethics

7. Theme 1: Life course  "I was unlucky:" a life replete with suffering, losses and uprootedness

8. Theme 2: Normality  "That's the way it is:" Self- neglect as a reality that had become normal routine

9. Theme 3: Old Age as an “ Amplifier ”  "They tell me that I'm disabled:" Old age as exacerbating situations of self-neglect.

10. Theme 4: “ My Empire ”  "My empire:" The person behind the self- neglect

11. Discussion  The broken and incoherent narratives;  “ Old age ” and self neglect;  The inappropriateness of paternalistic intervention;

12. Thoughts before ending...  Limitations;  The need for further research;  Ageism and self neglect in old age;  Policy Implications and the ethical dilemma;

13. Back to Diogenes:  It was in Corinth that a meeting between Alexander the Great and Diogenes is supposed to have taken place.Alexander the Great  While Diogenes was relaxing in the sunlight in the morning, Alexander, thrilled to meet the famous philosopher, asked if there was any favour he might do for him.  Diogenes replied, "Yes, stand out of my sunlight".

14. Thank you very much.  Dr. Israel (Issi) Doron;  Dr. Tova Band-Winterstein;  Mrs. Sigal Naim;  Department of Gerontlogy  University of Haifa, Haifa, Israel