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Self-neglect

Sometimes people don’t look after themselves properly. Self-neglect covers a wide range of behaviour such as neglecting to care for one’s own personal hygiene, health or surroundings.

What is self-neglect?

Self-neglect includes behaviour which risks someone’s health and wellbeing. Neglecting their personal hygiene or home cleanliness over a long time or access to essential work on utilities such as heating, electricity may be indicators of self-neglect.

It can also include hoarding, having poor diet and nutrition, repeatedly refusing access to health and social care staff and refusing treatment, medication or equipment intended to help them.

Self-neglect can be difficult to spot. Adults have a right to choose the lifestyle they want. Adults should be free to decide how they wish to live, what they want to eat, how often they wash and about their health. Adults have right to make unwise decisions. However, when an adult makes choices that put their health and wellbeing at serious risk, steps may need to be taken to safeguard them from harm.

What are the signs of self-neglect to look out for?

Someone maybe be suffering from self-neglect if they always looks dirty, their home is dangerously cluttered, untidy or unhygienic or the person is not taking important medication.

If the person is not following important medical advice they may be suffering from self-neglect. Perhaps the person won’t let health professionals, such as community nurses, visit them or the person repeatedly fails to attend medical appointments or may not be registered with a GP/doctor.

Who is more likely to neglect themselves?

Some people may be more likely to suffer from self-neglect. As people become frailer and less able as they get older, they may change their behaviour and take worse care of themselves.

They may have a learning disability, brain injury/damage or dementia or have mental health needs. People who have an alcohol or substance dependency or who live alone and don’t have a network of support from friends and family may also be prone to self-neglect.

What can be done about self-neglect?

It can be complex working with people who self-neglect. We have to balance people’s right to choose their lifestyle with the need to prevent harm.

To get the balance right, we assess whether the person has the mental capacity to understand the choices they are making, retain the information and weigh up the possible outcomes of their unsafe lifestyle and choices.

If we decide the person lacks mental capacity to make those choices, any action we take must be in the person’s best interests.

We assess the risks involved in the person continuing their lifestyle, behaviour or choices and we check whether the person is getting the right help and support to meet their care and support needs. Where needed, we will appoint an advocate to help and support the person.

We work together with other organisations and professionals who may be able to help, such as the London Fire Brigade, housing and medical professionals so that we can agree a way forward together. We keep the adult or their advocate involved and at the centre of any safeguarding plan.

I’m worried about someone. What should I do?

If you are worried that someone is neglecting themselves and putting their health or wellbeing at serious risk, please get in touch with our Access and Advice Service.

It takes courage to speak up about someone but by doing so you may help to prevent serious harm.

You can call Islington Access and Advice Service (Adult Social Services) on 020 7527 2299 or you can email access.service@islington.gov.uk. Our Minicom number is 020 7527 6475.

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