Diogenes Syndrome is a debilitating behavioral affliction where the sufferer becomes severely neglectful of themselves and their surroundings. It is most often seen in people over the age of 60, though middle-aged adults have also been diagnosed. Approximately 5 in every 10,000 individuals 60 years or older who live alone are diagnosed annually. Patients typically live alone and, while obvious to outsiders, are unaware that there is anything wrong with their living conditions. Symptoms include an extreme lack of personal hygiene, filthy homes, hoarding, withdrawal from social activities and a complete sense of apathy toward their situation. This disregard may stem from denial of the situation.
Diogenes Syndrome is triggered as a reaction to an endured stress such as illness, loss of a loved one, addiction or a mental illness. Symptoms develop slowly over a period of time making diagnosis difficult. Early on, they may include inappropriate behavior, a change in personality and a lack of good judgement. Living conditions set the stage for a myriad of problems. The home falls into a state of neglect, leading to animal infestation. It is often through injury or illness that this condition becomes known to friends and loved ones. Diogenes Syndrome can fall into two categories: Primary Diogenes Syndrome and Secondary Diogenes Syndrome.
The primary version is diagnosed when there is no accompanying diagnosis of a mental illness. When there is a mental illness present, the secondary version is diagnosed. A doctor will consider the patient’s personal and social history to help determine the presence of Diogenes Syndrome. A physical exam and imaging tests may also be establish any possible underlying causes. Treatment includes the use of medication, cognitive therapy and support groups. The following eight warning signs may indicate medical treatment is necessary.
1. Skin Rashes Caused By Poor Hygiene
Those suffering from Diogenes Syndrome are completely indifferent when in it comes to personal hygiene. It may be days or weeks in between baths, if they cleanse at all. This can lead to dermatological issues. Skin rashes may form on one or more parts of the body, even the scalp. There are many different types of fungi and bacteria that naturally live on the skin. Regular bathing helps to keep these in check. When the skin is not cleaned, these fungi and bacteria can increase uncontrollably causing infections and rashes.
Candida, Athlete’s foot, jock itch and tinea are some of the more common rashes that occur. Bathing is the best way to avoid skin rashes as the scrubbing process helps to eliminate dead skin cell, germs and oils; however, for someone suffering from Diogenes Syndrome, the ambition to be clean just isn’t there. Sufferers may also itch or pick at existing rashes, thus causing them to spread further on the body. This discomfort would usually be enough for a person to bathe, but Diogenes Syndrome sufferers may not be conscious of the discomfort or care enough to take steps for relief.
[nextpage title=“Next” ]2. Matted Unkempt Hair
One of the first signs that a person is not taking proper care of themselves is unkempt hair. Those suffering from Diogenes Syndrome rarely take the time to wash and brush out their locks. Without proper brushing and cleansing, the hair that is naturally shed becomes knotted and wrapped around other strands. Over time, this leads to matting in various areas. The matting may become so bad that it would need to be cut out. Sufferers may even have foreign objects tangled throughout their hair that go completely unnoticed. Hair will stink from lack of washing.
[nextpage title=“Next” ]3. Overgrown Toe And Finger Nails
Along with hair, Diogenes Syndrome sufferers very often fail to properly maintain their toenails and fingernails. This causes nails to become long and jagged from breakage. Nail fungus often develops leaving nails brittle and discolored. Long fingernails disrupt finger dexterity. Long toenails can cause problems when shoes are worn. Shoes place pressure on the toenail which may lead to the nail becoming loose or cause damage to the skin lying under the nail. This damage may cause the entire nail to tear off. It could also cause enough damage that the nail just falls off.
[nextpage title=“Next” ]4. Body Odor
To put it bluntly, sufferers of Diogenes Syndrome generally stink. Bad. The overall lack of personal hygiene causes all kinds of odors to emanate from their bodies. Apocrine glands located in the underarms and genitals and eccrine glands located in the hands, feet and underarms secrete a foul odor when skin bacteria is not properly washed off. Dirt and sweat locked into hair also gives off a most unpleasant smell. Fungus under the nails and between the fingers and toes add to the stench. Combined, these smells can be overwhelming, though the sufferer typically does not notice.
[nextpage title=“Next” ]5. Unkept Appearance
Along with a failure to keep their bodies clean, sufferers of Diogenes Syndrome generally fail to keep their clothes clean. It may be a numerous days before they change an outfit. Clothes become stained, worn and develop a stench. Body oils build up in the fabric making them feel somewhat slimey. This buildup can lead to body acne. Dirty clothes rubbing on skin can also cause rashes. While all these reasons would lead the average person to change into clean clothing, a person with Diogenes Syndrome is not bothered enough or not aware enough to do so.
[nextpage title=“Next” ]6. Unexplained Injuries
Senior citizens are especially prone to injury. Mobility becomes difficult, eyesight wanes and the skin becomes thin and fragile. The difference for those suffering from Diogenes Syndrome comes from the frequency and explanation behind injuries. Patients most often have a tendency to hoard. This leaves their home full of clutter that becomes a tripping hazard. Falls are common. Medical attention is typically delayed, if sought at all. Bruises, cuts and other injuries occur without the person noticing. Often times, it is through family and friends that injuries are not only noticed, but proper medical care is sought.
[nextpage title=“Next” ]7. Malnutrition
With such a sense of apathy when it comes to personal hygiene, it should come as no surprise that many sufferers of Diogenes Syndrome become severely malnourished. This condition develops either from a lack of food intake, or simply from eating foods with little or no nutritional value. Sufferers typically don’t pay attention to what or when they eat. When hungry, many simply munch on a piece of bread or eat a bag of junk food. It’s not uncommon for Diogenes Syndrome sufferers to become anemic. Early on, the failure to eat sustainable meals may cause weight loss.
[nextpage title=“Next” ]8. Dehydration
If a Diogenes Syndrome sufferer is malnourished, it can be just about guaranteed that they are also dehydrated. Older individuals tend to have a more muted sensitivity when it comes to thirst. Add to that an overall lack of concern and the stage has been set for dehydration to set in. Drinking sugary and caffeinated drinks can also contribute. Onset of dehydration occurs faster in seniors than in younger people. As the body ages, it holds less and less water making regular intake essential for good health. Chronic dehydration can lead to seizures, brain swelling and kidney failure.
