The Care Act 2014 defines self-neglect as wide ranging & covering:

• Neglecting to care for one’s personal hygiene
• Neglecting to care for one’s health
• Neglecting to care for one’s surroundings
• Hoarding

This could also involve refusal of services, treatment, assessments or intervention, which could potentially improve self-care or care of one’s environment. There are other less overt forms of self – neglect such as: eating disorders; misuse of substance; and alcohol abuse. 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.

Hoarding is the excessive collection & retention of any material to the point that it impedes day to day functioning. This can include:

• Inanimate objects (commonly clothes, newspapers, books, DVDs, letters & food/packaging)
• Animals
• Data

There are many reasons why a person hoards – they may believe an item will be useful or valuable in the future; they feel the item has sentimental value, or that if they throw it away they won’t be able to remember the person who gave it to them or the time they acquired it.

In some cases it may be a disorder that is present on its own or as a symptom of another disorder such as depression, obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHA).

Someone who hoards may exhibit the following behaviour:

• Inability to throw things away
• Severe anxiety when attempting to discard items
• Indecision about where to put things or what to keep
• Distress, such as feeling overwhelmed or embarrassed about their possessions
• Suspicion of other people touching items
• Obsessive thoughts and actions: fear of running out of an items or of needing it for the future
• Functional impairments such as the loss of living space, becoming isolated from family and friends, financial difficulties, health hazards in the home

The person must always be at the heart of any action to prevent further self-neglect. Consent must always be sought before action is taken – if the person concerned is able to give consent. The key aspects to assess are:

• Physical Living Conditions
• Mental Health
• Financial Issues
• Personal Living Conditions
• Physical Health
• Social Networks
• Personal Endangerment
• Danger to Others 

Please refer to the Recognising and Reporting Abuse webpage.