Self-Neglect and Hoarding: A Guide to Safeguarding and Support
| Published date | 07 March 2019 |
| Date | 07 March 2019 |
| DOI | https://doi.org/10.1108/JAP-02-2019-052 |
| Pages | 65-68 |
| Author | Michael Preston-Shoot |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Edited by Deborah Barnett
Jessica Kingsley Publishers
London
2018
264pp.
Review DOI
10.1108/JAP-02-2019-052
It is my experience as an Independent Adult
Safeguarding Cons ultant that practit ioners
and managers across health and social care,
and in agencies as diverse as environmental
health, police, fire and rescue and social
housing, find case s of adults who
self-neglect and hoard to be amongst the
most complex and challenging. The number
of safeguarding adult reviews (SARs) and,
prior to implement ation of the Care Act
2014, of Serious Case Reviews (SCRs) that
feature adults who self-neglect and hoard is
further evidence of the complex chal lenges
involved. These challenges comprise
features of direc t work with the indiv idual
concerned but also of the organisational and
inter-agency context of adult safeguarding
(Braye et al., 2015; Preston-Shoot, 2016,
2017, 2018). Consequently, practitioners
and managers will welcome a book that
offers guidance on how to work effecti vely
with adults at ris k of self-neglect.
Besides an introduction and conclusion, the
book mainly comprises seven chapters that
begin with defining self-neglect and hoarding
before moving on to discussion of how self-
neglect affects people’s lives and the themes
that emerge from the aforesaid SCRs and
SARs. There are then chapters on
safeguarding, therapeutic interventions,
assessment and engagement and finally
supporting the practitioners. A preface and
epilogue offer observations that address
ethical questions and implicitly if not explicitly
address the six principles (DH, 2017),
especially prevention, protection and
proportionality. This, then, is definitely a book
mainly for practitioners and their immediate
supervisors and managers. Its primary focus,
returning to the challenges that emerge from
SCRs and SARs, is on direct practice, with
some much more limited focus on the
organisational and inter-agency context for
effective practice. Ensuring that practitioners
have the knowledge and skills to work with
adults who self-neglect and hoard is crucial.
However, workforce development, to which
this book will contribute, has to be
accompanied by workplace development
(Braye et al., 2013). Put another way, for
practitioners to be able to practise by drawing
on the best research, review and practice
evidence available, brought together in work
such as this book, organisational and inter-
agency systems must be aligned to facilitate
this. All too often practitioners report that they
are required to work within systems that
frustrate and impede rather than promote
best practice.
A commitment to Making Safeguarding
Personal, either ex plicitly or implicit ly,
resonates throughout this book. It is
reflected, for example, in an important
acknowledgemen t of the emotions that
individuals may br ing to encounters wi th
statutory services, and of the importance of
understanding the meaning behind the self-
neglect and hoarding for interventions to be
effective in the long er term. There is a strong
focus on the values that practitioners bring to
this work and on the ethical considerations
that must be given spa ce in decision making.
There is a strong focu s on accountability, for
instance regarding practitioners and their
managers being able to give a defensible
account of their decision making.
The book tends to focus more on hoarding
than self-neglect, for example when exploring
definitions. Nonetheless, the chapter that
draws on research to understand what is self-
neglect and hoarding does provide an insight
into what might lie behind these behaviours.
Similarly, the chapter that covers the impact
of self-neglect and hoarding on individuals
and those they live with once again tends to
focus more on hoarding. However, it
emphasises some of the risks that should be
included in any assessment and it correctly
stresses the importance of “thinking family”.
Not all individuals who self-neglect and hoard
live alone. The dynamics between carers
Self-Neglect and
Hoarding: A Guide to
Safeguarding and
Support
VOL. 21 NO. 1 2019, pp. 65-68, © Emerald Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAG E 65
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