Self-neglect in adult life

Area of Science:

• Geriatric Medicine
• Psychiatry
• Social Work

Background:

• Self-neglect is a complex issue often presenting with domestic squalor and hoarding.
• It affects adults, sometimes without a formal psychiatric diagnosis, complicating intervention.
• Understanding the underlying factors, including personality traits, is crucial for effective management.

Observation:

• Two adult patients living alone presented with severe domestic squalor and extensive rubbish hoarding.
• Both patients had a history suggestive of schizoid and paranoid personality traits.
• Despite recommendations, both patients initially refused all forms of assistance.

Findings:

• Self-neglect presentation can occur in individuals without diagnosed psychiatric disorders.
• Personality traits, such as schizoid and paranoid, may be associated with self-neglect.
• Patient refusal of help is a significant barrier to addressing self-neglect.

Implications:

• Protected accommodation appears to be a key intervention for improving self-neglect outcomes.
• Multidisciplinary approaches involving social work and mental health professionals are essential.
• Further research is needed to understand the long-term efficacy of different interventions for self-neglect.