Social care responses to self-neglect and hoarding among older people: what works in practice?

John Woolham In progress  


Self-neglect and hoarding are challenging parts of adult social care practice. They encompass squalor or neglecting self-care and hygiene – which in different ways manifest unwillingness or inability to care for oneself and/or one’s environment. Although a growing body of research examines self-neglect, there is limited information on its prevalence; in part due to different study populations and methodological inconsistency.

Self-neglect is associated with adverse outcomes on physical and psychological well-being, mortality, health and social care utilization. One manifestation of this is hoarding behaviour. Hoarding at its most extreme leads to lives that are lived in squalor but also other risks (such as preventable fire fatalities).

Debate continues as to how self-neglect should be understood – for example as a psychiatric diagnosis or a social construct.


The overall aim of this exploratory study is to improve practice understanding of what works in responses to self-neglect and hoarding among older people from a social care perspective.


This study is using a mixed-methods approach. The literature and policy review phase will involve:

  1. Analysis of research literature on hoarding and self-neglect
  2. Review of national and local policy on hoarding and self-neglect
  3. Review of published literature on the perceptions/experiences of practitioners and of service users/those with personal experience/clients of hoarding and self-neglect.

Working with six sites in England, interviews will be carried out with safeguarding managers, practitioners and service users and family members.

An exploratory evaluation of the economic impact of self-neglect and hoarding among older people will be carried out.