Self-neglect

The term self-neglect is commonly used to describe a person's inability or unwillingness to care for their basic needs. There isn't one agreed definition, and the term can encompass several different behaviours. These include not managing personal hygiene, avoiding or refusing to undertake essential tasks, refusing services that can help improve wellbeing, or hoarding. Self-neglect can lead to physical and/or emotional harm.

Learning Review: Adult O (East Ayrshire)

This review relates to the care and protection arrangements for Adult O, age 81. Adult O lived alone and died from injuries caused by a house fire in the early hours of the morning on 22 February 2022, following a visit to the Emergency Department the day before.

Themes and learning points in this review include:

* joint working and clarity of roles/responsibilities

* self-neglect

* the right to protection versus the right to self-determination

* the role of housing.

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Identifying and Responding to Hoarding: Good Practice Guidance (East Lothian and Midlothian Public Protection Committee)

This resource supports good multi-agency practice in identifying and responding to hoarding. It helps people to identify, understand and respond skillfully to hoarding in a trauma-informed way. The resource also outlines the responsibilities of the key statutory agencies. At the end, the guide has a useful checklist for managerial oversight of hoarding cases and a resource list of links to videos about hoarding, including input from adults who have lived experience of hoarding.

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Self-neglect and hoarding protocol and toolkit: Practitioner guidance (Orkney)

The aim of this Self Neglect and Hoarding Protocol and Toolkit is to provide practitioners in Orkney with a toolkit for assessment and intervention, where appropriate. The guidance contains information on what hoarding and self-neglect are, legal duties, and good practice principles. There are additional information and images from the Clutter Image Rating Scale (CIRS) and the practice implications of each level.

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Iriss outline: An overview of self-neglect

Self-neglect is one of the key challenges in Adult Support and Protection. Research has identified that health and social care professionals often find self-neglect cases personally and professionally difficult. Ethical and legal considerations, particularly where adults have the mental capacity to refuse support, can be particularly challenging. This briefing sets out key knowledge on self-neglect, including definitions, potential causes, impacts, and directions for future research. Part of the Iriss outline series.

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Seen something? Say something

Adult Support and Protection is everyone's business. This video animation, made for Scotland’s national Adult Support and Protection Day 2023, highlights the signs of self-neglect and neglect. The video is especially useful in highlighting the role that people in the community have in raising concerns. The particular context of this video is the cost-of-living crisis, which may make day-to-day decisions harder. This, in turn, can impact on people's ability to look after themselves or others around them.

Hoarding and self-neglect video (Dundee)

This video, presented by Lisa Cox of Scottish Fire and Rescue, defines a hoarding disorder and its key attributes. It looks at origins, prevalence, risk, assessment, and effective working with people affected by hoarding. The video also covers Diogenes Syndrome (DS).

Hoarding and self-neglect: Podcast (Clackmannanshire)

Podcast between Neil Whettam (Learning and Development Advisor, Clackmannanshire) and Paul Comley (National Adult Support and Protection Co-ordinator) about hoarding and self-neglect. Covers what hoarding and self-neglect are, choice, capacity, assessment frameworks, and research. Working in these areas can be very challenging and this podcast supports individual and team reflection on these areas of practice. 30 minutes long.

Self-neglect and hoarding guidance (Aberdeen)

This multi-agency guidance for managing self-neglect, hoarding and non-engagement provides a framework to complement any single agency protocol or guidance. It includes material on defining the issue, assessment, information sharing, working together to find solutions, and addressing non-engagement with services. The guidance is accompanied by several appendices, including checklists, infograms and pathways.

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Learning from Learning Reviews: Self-neglect and hoarding (Aberdeen)

This video and one-page briefing share practice from Aberdeen's experiences when working with people with hoarding and/or self-neglecting behaviour. The material prompts practitioners to think about what might be the reasons for the person's behaviour and the possible impacts. It also addresses when an Adult Support and Protection referral should be considered. Relationship building, multi-agency working, and the balance of 'choice' and risk are all considered.

The ASPire Hub is a place for everyone working in Adult Support and Protection in Scotland to access and share resources. It is regularly updated and we welcome feedback and new additions!