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

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.

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.

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.

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.

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.

This article summarises and critically analyses the emerging key features of evidence‐informed practice in the challenging field of self‐neglect.