Intervention and social breakdown in the elderly.

Objective: To discuss the ethical and clinical issues associated with the management of social breakdown in the elderly (SBE) in relation to the case of a 76-year-old recluse who was referred following community concerns about her living conditions and behaviour.

Method: Longitudinal assessment and management of the patient resulted in a diagnosis of schizophrenia and treatment with fluphenazine decanoate.

Results: The patient responded to treatment and was returned home, after which a relationship was maintained by community services.

Conclusions: A coherent and defensible position on both clinical and ethical grounds may be made in favour of intervention with SBE. Practical aspects of the process are suggested.