Conceptualising and responding to self-neglect: the challenges for adult safeguarding

Abstract

Purpose – The research reported here aims to scope the concept of self-neglect as it is explored in the literature and interpreted in practice by professionals involved in adult safeguarding. Design/methodology/approach – The approach taken included a systematic search and thematic analysis of English-language literature on self-neglect, workshops with UK-based adult safeguarding leads and practitioners from social services, police and health services, and scrutiny of Safeguarding Adults Boards’ documentation. Findings – The concept of self-neglect is complex with contrasting definitions and aetiology, accompanied by debates on the principles that guide intervention. Decision-making capacity is a key pivot upon which professional responses to self-neglect turn. Intervention in self-neglect requires careful exploration in the context of principles of personalisation, choice, control, and empowerment that underpin policy in adult social care and safeguarding. Research limitations/implications – As a conceptual scoping review, this study seeks to establish broad themes of use to practitioners working with self-neglect. It thus does not carry out a full quality review of the literature identified and discussed, but serves as a base for this to be done in future. Practical implications – Assessment in self-neglect should consider the influence of a number of possible causative factors, and intervention must balance respect for autonomy on the one hand and a perceived duty to preserve health and wellbeing on the other. Originality/value – This article summarises and critically analyses the emerging key features of evidence-informed practice in the challenging field of self-neglect.