Self-neglect

Self-neglect is a behavioral condition in which an individual neglects to attend to their basic needs, such as personal hygiene, appropriate clothing, feeding, or tending appropriately to any medical conditions they have. More generally, any lack of self-care in terms of personal health, hygiene and living conditions can be referred to as self-neglect. Extreme self-neglect can be known as Diogenes syndrome. Self-neglect is a behavioral condition in which an individual neglects to attend to their basic needs, such as personal hygiene, appropriate clothing, feeding, or tending appropriately to any medical conditions they have. More generally, any lack of self-care in terms of personal health, hygiene and living conditions can be referred to as self-neglect. Extreme self-neglect can be known as Diogenes syndrome. Self-neglect can be as a result of brain injury, dementia or mental illness. It can be a result of any mental or physical illness which has an effect on the person's physical abilities, energy levels, attention, organisational skills or motivation. A decrease in motivation can also be a side effect of psychiatric medications, putting those who require them at a higher risk of self-neglect than might be caused by mental illness alone. There is no clear operational definition of self-neglect - some research suggests it is not possible for a universal definition due to its complexity. Gibbons (2006) defined it as: 'The inability (intentional or non-intentional) to maintain a socially and culturally accepted standard of self-care with the potential for serious consequences to the health and well-being of the self-neglecters and perhaps even to their community.' The behaviors and characteristics of living in self-neglect include unkempt personal appearance, hoarding items and pets, neglecting household maintenance, living in an unclean environment, poor personal hygiene, and eccentric behaviors. Research also points to behaviors such as unwillingness to take medication, and feelings of isolation. Some of these behaviors could be explained by functional and financial constraints, as well as personal or lifestyle choices. There are two types of self-neglect, intentional (active) and non-intentional (passive). Intentional occurs when a person makes a conscious choice to engage in self-neglect. Non-intentional occurs as a result of health-related conditions that contribute to risk of developing self-neglect. Different societies or health care staffs can have different beliefs regarding acceptable living standards, making self-neglect a serious and complex problem requiring clinical, social, and ethical decisions in its management and treatment. It is key to establish a trusting, therapeutic relationship with a person who is engaging in self-neglect because restricting autonomy can be harmful. Lauder et al. (2005a) suggested the best-practice approach is not to force services on the person. Age-related changes that result in functional decline, cognitive impairment, frailty, or psychiatric illness increase vulnerability for self-neglect. For this reason, it is thought that, while self-neglect can occur across the lifespan, it is more common in older people. Self-neglect is thought to be linked to underlying mental illnesses. Risk factors are: Living in squalor is sometimes accompanied by dementia, alcoholism, schizophrenia, or personality disorders. Conversely, research has shown that 30–50% people suffering from self-neglect have shown no psychiatric disorders that would explain their behavior. Alternate models to the medical model, such as sociological and psychological, offer broader perspectives that take into account the complexities and factors associated with self-neglect. These alternate models emphasize cultural and social values and personal circumstances, and posit that self-neglect develops over time and can be rooted in family relationships and cultural values.