What is Self-Neglect?
Self-Neglect is when someone:
- Neglects their personal hygiene
- Neglects to care for their own health (this can include drug or alcohol misuse/dependency)
- Neglects to care for their own surroundings
- Hoarding (excessive collection and retention of any material to the point that it impedes day to day functioning). This can include things like:
- Books, magazines, newspapers
- Toys, videos, DVDs, CDs
- Letters, leaflets and papers
Self-Neglect can also involve refusal of services, treatment, assessments or intervention, which could potentially improve self-care or care of one’s environment.
Self-Neglect differs from other safeguarding concerns as there is no perpetrator of abuse, however, abuse cannot be ruled out as a purpose for becoming self-neglectful. Self-Neglect can be a complex and challenging issue for practitioners to address, because of the need to find the right balance between respecting a person’s autonomy and fulfilling a duty to protect the adult’s health and well-being. The Mental Capacity Act 2005 is crucial in determining what action may or may not be taken in cases of Self-Neglect
Spotting the Signs of Self-Neglect
- Poor hygiene
- Dirty or inappropriate clothing
- Poor hair and/or nail care
- Unmet medical or health needs
- Alcohol and/or drug misuse/dependency
- Eating disorders
- Social isolation
- Unsanitary, untidy or dirty conditions which create a hazardous situation that could cause serious physical harm to the individual or others or a potential fire risk
- Poor maintenance of property
- Keeping lots of pets who are poorly cared for
- Vermin at the person’s property
- Lack of heating
- No running water and or lack of sanitation
- Poor financial management, including not paying bills which leads to utilities being cut off
- Refusal of care services in home
- Refusal of care services in care environment
- Refusal of health assessments
- Refusal of health interventions
For further information about Self-Neglect, please see the Board’s Self-Neglect Policy, Procedures and Guidance.
What is Drug and Alcohol Misuse/Dependency?
Drug and Alcohol misuse is defined as drug and/or alcohol taking, which causes harm to the individual, their significant others or the wider community. The term ‘drug’ refers to ‘psychoactive drugs including illicit drugs, ‘legal highs’ and prescribed and non- prescribed pharmaceutical preparations.’ The term misuse refers to the ‘illegal or illicit drug taking or alcohol consumption, which leads a person to experience social, psychological, physical or legal problems related to intoxication or regular excessive consumption and/or dependence’.
Alcohol or drug misuse/dependency may lead or escalate to Self-Neglect.
It may be that the individual initially does not wish to engage or obtain support, multi-agency working may be the key to engagement, as well as building up a level of trust and rapport with the individual. On occasions repeated intervention is required and progress may be slow, often the cases that give rise to the most concern are those in which the individual declines help and support and is seen to be at grave risk as a result.
It is important that professionals talk openly and honestly with individuals and apply the Making Safeguarding Personal principles of; ‘no decision about me without me’. Professionals should also adopt the Think Family approach and consider others that may be impacted by Self-Neglect such as children or animals.
If you think someone with care and support needs is neglecting themselves you can contact your Local Authority or for hoarding matters your Environmental Health Office for advice.
There are a number of websites or support services available (links below) for hoarding, drug and alcohol misuse and mental health support.