During my days as a Council on Aging director I remember getting calls from people worried about an old person who was neglecting her own wellbeing. She may have been looking malnourished, for instance, or have been letting her small apartment fill up with old clothes and other junk. The caller, often a family member or neighbor, would feel anxious about the harm the elder was doing to herself and wonder how to prevent it.

Home care providers, social workers, and other professionals who help elders in their homes are very familiar with situations like this. And they are usually resourceful in knowing what steps to take that will improve the situation. Massachusetts stands out for having strong networks of services designed to meet needs experienced by older residents.

For more than two decades, this commonwealth has benefited from a protective services law that requires a wide variety of professionals to report incidents of abuse of people over age 60. These so-called mandated reporters include medical personnel, police officers, firefighters, licensed psychologists, and many others.

These service providers must report to a designated elder service agency if they suspect physical, emotional, or sexual abuse, as well as caretaker neglect and financial exploitation.  These forms of abuse occur at the hands of a third party and, regrettably, have been found to be dismayingly widespread.  Last year, the state provided almost ten million dollars to fund protection for elders subject to these kinds of abuse.

Now, by virtue of a new law passed this year, abuse and neglect inflicted by oneself has been added to the categories of abuse that must be reported. Passage of this addition to the law comes in response to a multi-year effort by an organization called Mass Home Care, along with other advocates. I owe information about this to Al Norman, the long-time director of Mass Home Care and an outstanding champion of elder citizens. His monthly newsletter comes filled with important data about legislative matters and other matters affecting older people.

Norman describes the addition thus: “The new self-neglect provision is defined as the inability of an elder to meet his/her essential needs for food, clothing, safe and secure shelter, personal care supervision and medical care to the point where he/she cannot remain safely in the community without assistance.”

Though a larger number of people are expected to need attention this year, the legislature has underfunded the new program by a million dollars. That means hundreds of self-neglecting elders will go without needed services.

Still, even without adequate funding, many advocates feel happy about the extension of the law to include self-neglect. John O’Neill, for the past 25 years executive director of Somerville-Cambridge Elder Services, hails it as “another tool to help.”

“This gives us the ability to raise the question,” he adds in reference to situations in which elders appear to be neglecting their own basic needs.

However, I must confess feeling some qualms about the wisdom of mandating by law the reporting of what could be expressions of elders’ free choices about their lives. People sometimes make assumptions about the mental balance of their elders when the latter merely choose to act in an unconventional manner. We must be careful to respect their right to do so.

I am supported in this cautionary note by a veteran advocate of elders, a skilled and compassionate person for whom I have high regard. She also feels the need to safeguard older peoples’ autonomy and independence. After all, we elders have the same right to neglect our own wellbeing that people of other ages have. It can amount to others poking their noses into our business if our freedom to be ourselves is judged as needing intervention.

Realistically, however, many of those whose cases will be reported do suffer from illness or disability that restricts their ability to recognize their own best interest. They may have some form of dementia, making it difficult to know what is happening to them. In such instances, reporting their situation seems clearly to be doing them a service that can make a crucial difference in their lives.

In any event, reporting how things are for the elder does not settle the case. Rather, it is the first step in a procedure in which others will be involved, others who are required to be sensitive to the rights of the older person. These protective service personnel must weigh carefully the circumstances and respect the person’s dignity and autonomy.

Provided that those who “raise the question” exercise prudence and respect the often fine line between independence and mental impairment, I will welcome the new legislation. Ideally at least, it is another sign of our belonging to a community of caring. Even though putting it in legal terms can make this caring seem bureaucratic, it really does give expression to our living in a commonwealth of concern.

Richard Griffin