When considering adults, neglect is the ongoing failure to meet an individual’s basic and essential needs, either deliberately, or by failing to understand these.

It includes ignoring a person’s needs, or withholding essentials to meet needs, such as medication, food, water, shelter, and warmth. This can include acts like not getting enough to eat or ignoring an individual’s medical or physical care needs. Everyone has the right to access the necessities of life, such as food, shelter, clothing, heating, stimulation, and activity.

Types of neglect or acts of omission can include:

• failure to provide or allow access to food, shelter, clothing, heating, stimulation, and activity, personal or medical care
• providing care in a way that the person dislikes
• failure to administer medication as prescribed
• refusal of access to visitors
• not taking account of individuals’ cultural, religious, or ethnic needs
• not taking account of educational, social, and recreational needs
• ignoring or isolating the person
• preventing the person from making their own decisions
• preventing access to glasses, hearing aids, dentures, etc
• failure to ensure privacy and dignity

Possible indicators of neglect can include:

• poor environment, for example dirty or unhygienic
• poor physical condition and/or personal hygiene
• pressure sores or ulcers (Department of Health pressure ulcer guidance for professionals)
• malnutrition or unexplained weight loss
• untreated injuries and medical problems
• inconsistent or reluctant contact with medical and social care organisations
• accumulation of untaken medication
• uncharacteristic failure to engage in social interaction
• inappropriate or inadequate clothing

Self Neglect

Self-neglect is an extreme lack of self-care, it is sometimes associated with hoarding and may be a result of other issues such as addictions. Practitioners in the community, from housing officers to social workers, police and health professionals can find working with people who self-neglect extremely challenging. The important thing is to try to engage with people, to offer all the support we are able to without causing distress, and to understand the limitations to our interventions if the person does not wish to engage.

Self-neglect can include:

• lack of self-care to an extent that it threatens personal health and safety
• neglecting to care for one’s personal hygiene, health, or surroundings
• inability to avoid harm as a result of self-neglect
• failure to seek help or access services to meet health and social care needs
• inability or unwillingness to manage one’s personal affairs

It is not always possible to establish a root cause for self-neglecting behaviours. Self-neglect can be a result of:

• a person’s brain injury, dementia or other mental disorder
• obsessive compulsive disorder or hoarding disorder
• physical illness which has an effect on abilities, energy levels, attention span, organisational skills or motivation
• reduced motivation as a side effect of medication
• addictions
• traumatic life change and Adverse Childhood Experiences

Sometimes self-neglect is related to deteriorating health and ability in older age and the term ‘Diogenes syndrome’ may be used to describe this. People with mental health problems may display self-neglecting behaviours. There is often an assumption that self-neglecting behaviours indicate a mental health problem but there is no direct correlation.

Hoarding is now widely considered as a mental health disorder and appears in the US ‘Diagnostic and statistical manual of mental disorders’ (5th Edition). Hoarding can sometimes relate to obsessive compulsive disorder, but hoarding and self-neglect do not always appear together, and one does not necessarily cause the other.

The Barking and Dagenham Safeguarding Adult Board (SAB) is made up of a number of key partners from across social care, health, the police and the community. The SAB has a statutory duty to ensure that it safeguards people from abuse and neglect. 

The SAB has developed a Self Neglect and Hoarding Policy to support professionals who work with people who are at high risk of significant harm due to self-neglect. It aims to help professionals identify cases, manage the risks and safeguard people through coordinated multi agency partnership approaches, in a way that supports the person(s) involved.

SAB Self Neglect and Hoarding Policy (PDF, 6.24 KB)