CONTENTS
1. What is Self-Neglect?
Self-neglect covers different behaviours including, hoarding, animal collecting, risky behaviour, not eating or drinking properly, not being able to keep a clean and tidy home environment, failing to look after their personal hygiene, finances, social contact or protect themself from abuse.
The causes of self-neglect may include poor physical health, mental health, poor access to support, poverty, pain, poor diet, past trauma including wartime experiences, physical / sexual abuse or drug or alcohol misuse.
Such cases may start discussions between staff of whether it is personal choice of how a person lives or if they cannot protect themselves. For this reason, cases of self-neglect should be considered on a case by case basis.
A person who self-neglects or hoards may not have full mental capacity. If there is a concern they may not have mental capacity, a trained member of staff should complete a mental capacity assessment with them.
2. What is Hoarding?
Hoarding is a type of self-neglect, where adults have many, many items and store them in a random way, usually resulting in unmanageable amounts of clutter. Often items can be of little or no financial value, like old newspapers or junk mail.
Hoarding is considered a significant problem if:
- the amount of clutter interferes with their everyday living, for example, if they can no longer use their kitchen, bathroom or any other rooms;
- the clutter is causing them distress or negatively affecting their quality of life or that of other family members.
3. Who is at Risk?
Self-neglect is mostly an issue for older people, particularly if people have poor mental health, long term physical illness, are socially isolated or are depressed.
It can, however, also affect younger people. They may be less likely to hoard things but may live in unhygienic living conditions, have mental health problems, misuse drugs or alcohol or have a chaotic lifestyle.
4. Working with People who Self-Neglect or Hoard
Trained staff will work with the adult, and their family where appropriate, to develop a care plan with them to help them improve the quality of their living conditions.
People who self-neglect or hoard may feel very anxious that other people will come into their home and throw their possessions away. Therefore they have to be at the centre of discussions and plans to make improvements and such interventions have to be done at their pace, with their consent and done together with them.
It is essential that staff who work with the adult in such situations has a good relationship with them. This may mean that there are a number of visits at first to get to know each other so the adult can start to trust staff, before attempting to make signficant changes.
Staff who have developed the care plan with the adult will communicate how this is to be done with care workers, and let them know what is needed of them on home visits. Care workers will need to complete records about progress that is made or any issues of concern.
