What we will cover
What is self-neglect
Why might people self-neglect
The impact on a person’s health
What to look out for
Scenarios
Self-neglect
‘Self neglect covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding’
(Care and Support Guidance 2015)
‘the inability (intentional or non-intentional) to maintain a socially and culturally accepted standard of self-care; …with the potential for serious consequences to the health and well-being of the self-neglecters and perhaps even to their community.’
Gibbons (2006)
Risk assessment…
• Circumstances in which they occur
• Historical information
• Current circumstances
• Communication
• Investigation
• Observation
• Persistence
Gathering Information
Analysis
Specific Risk Factors
Anticipate Possible Change
Southampton City Council (2013)
Risk factors…
…how risky is it?
Risk events themselves can be analysed by
likelihood against impact
This can help service users and professionals
prioritise which risk events to focus on
Risk factors…
…and interventions
Dynamic
Deep clean
Respite
Admit to Hospital
Mental Health Act
Residential care
Static/stable
Therapeutic interventions (e.g. CBT)Relationships & engagementLonger-term workAddress underlying causes
Why might people self-
neglect?Pride / embarrassment
Culture or values of self-sufficiency
Attachment to place and possessions
Social Isolation
Mental Illness
Loss of carer
Functional decline
Frailty
Cognitive impairment
Lack of financial resources
The (undue) influence of others
Health-related cause?
Depression
Obsessive Compulsive Disorder
Schizophrenia / Paraphrenia
Dementia
Diogenes syndrome
Dependence on others
Frailty
Learning disability
Impact on health…
Pressure injuries
Depression
Malnutrition
Dehydration
Food poisoning
Infection
Diabetes management
Respiratory complications
A balance of rights…
Autonomy
Independence
Self-determination
Human Rights
Unwise decisions
‘My home is my castle’
Impact on health
Duty of Care
Family concerns
Impact on Community
Professional opinion
Empowerment
Making Safeguarding Personal