News and presentations from today's conference chaired by Suzy Braye OBE, Emerita Professor of Social Work, University of Sussex.
EXTENDED SESSION: Safeguarding people who self-neglect: what works?
Suzy Braye OBE Emerita Professor of Social Work
University of Sussex
This session draws on evidence from the presenter's research (with David Orr and Michael Preston-Shoot) into effective practice in self-neglect; it considers:
• the range and scope of self-neglect work nationally
• the challenges experienced in practice
• what goes wrong – findings from safeguarding adult reviews in cases of
self-neglect
• what goes right - service users’ and practitioners’ perspectives on approaches
that support positive outcomes
• effective interagency working in self-neglect
Suzy said guidance covers Self Neglect in a very broad way, it can be considered an umbrella term for neglect of self care or neglect of the domestic environment including 'Hoarding Disorder'. This would be behaviour that is to such an extent that it endangers our health, safety and wellbeing. Suzy went on to look at the 6 key challenges from evidence: understanding causation, ethical dilemmas, mental capacity, legal rules, organisational features, and interagency cooperation.
"A third of people who die in fires are hoarders" "Safeguarding Adult Reviews in London found one of the leading causes of death to be self neglect"
Hoarding is used as a form of self protection. A multi-agency approach is needed to support people with hoarding behaviour, it is a long-term condition. Suzy said best practice for supporting people who self neglect includes:
- understanding the issue, this could be:
- negative self image: demotivation
- different standards: indifference to social appearance
- inability to self care
- working collaboratively with other professionals
- working with individuals at their own place over the long term
It is important to consider ethical dilemmas - respect for autonomy and self determination vs duty to protect and promote dignity.
Suzy said we really need to challenge our assumptions and consider if interventions are really protecting people for example when they are discharged from hospital after their home has been cleared, often they are not supported with that.
EXTENDED SESION: Self Neglect & Covid-19
Wendy Proctor Designated Nurse Adult Safeguarding
Sunderland Clinical Commissioning Group
• the impact of the pandemic on Self Neglect
• partnership working across health and social care
• identification of self-neglect
• managing risk and supporting a strengths based way of working to work
together to identify meaningful solutions
• managing resistance to engage with services
• outreach to clinically vulnerable resident
• examples of good practice