33% of safeguarding concerns received in H&F in 2022-23 related to self-neglect.
Introduction
National analysis of Safeguarding Adults Reviews has also identified self-neglect as a leading category of abuse, featuring in 45% of cases (2017 to 2019).
Key messages
Relationships
Relationship building is crucial. Try to really get to know the person and ‘get alongside’ them, show interest and concern. Communicate clearly and regularly with the person.
Curiosity
Try to find out why the person is self-neglecting – this may be connected with trauma, grief, mental health episodes or other experiences.
Don’t just look at the current picture, try to piece together the person’s life story and find out what is important to them.
Risk
Undertake a thorough risk assessment and explain your concerns openly to the person who is self-neglecting.
Support
Look at the person’s family network and any community networks and think about how these might help support the person.
Partnership
Be clear about your role and responsibilities and those of others. Think about how to link up with other agencies involved to ensure a joint approach.
Share the risk and ensure that everyone understands that persistence and commitment require time.
Decision-making
Consider mental capacity in relation to the decisions which need to be made. Also consider the possibility of fluctuating capacity and the person’s ‘executive functioning’ – they may appear to understand but can they or will they see the decision through in action?
Patience
Be patient and work at their pace. Be prepared for long-term involvement – self-neglect situations are rarely resolved quickly.
Understanding
The term ‘self-neglect’ can be perceived as a very stigmatising and emotive term – be careful how you use it. Don’t dismiss self-neglect as a ‘lifestyle choice’ or take an initial rejection of support as final.
Work on shared goals, not goals based on how you think they should live.