Self Neglect

There is no one definition of self-neglect, but the term is used to cover a wide range of behaviour of a person neglecting their own health, personal hygiene or their surroundings and includes behaviour such as hoarding.

The type of behaviour that are considered to be self-neglecting include;

• lack of self-care and not attending to personal hygiene, nutrition and hydration, or health needs, to an extent that it may endanger their safety or wellbeing
• lack of care of environment and living in situations that could lead to domestic squalor or elevated levels of risk in the domestic environment (for example, health or fire risks caused by hoarding)
• refusal of assistance that might alleviate these issues. This might include, for example, refusal of care services in either their home or a care environment or of health assessments or interventions, even if previously agreed, which could potentially improve self-care or care of one’s environment

There are various reasons why people self-neglect. Some people have insight into their behaviour, while others do not. It can occur as a result of mental health issues, personality disorders, substance abuse, dementia, advancing age, social isolation, and cognitive impairment or through personal choice. It can be triggered by trauma and significant life events. Self-neglect is an issue that affects people from all backgrounds.

Case Study

Jenny lives alone. She has been diagnosed as having a severe compulsive disorder which manifests itself in hoarding. Jenny experiences high levels of anxiety which impacts on her ability to attend to personal care and eat. There are unopened bags of cooked food that Jenny says she has forgotten to eat. Jenny says she is aware of the risk to her health and environment and has noticed mouse droppings in the kitchen. She says she does not clean her home as it causes her anxiety to move things and throw things away.

Jenny gathers all her post but doesn’t open any letters. Jenny only goes out to familiar places where there are familiar faces.

The Local Authority received a concern about risk of harm through self-neglect. After checking with mental health services, it was found that Jenny had recently seen a psychiatrist. The psychiatrist was contacted and has a clear view that Jenny has full mental capacity to understand these risks, how her mental disorder affects these risks, and to make decisions about her care and support needs.