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Article
Publication date: 19 May 2022

Jennifer N. Howard, Helena Voltmer, Abigail Ferrell, Nikki Croteau-Johnson and Michael Lepore

Self-neglect is a public health concern that can manifest as failure to provide oneself adequate food, water, clothing, shelter, personal hygiene, medication or safety…

Abstract

Purpose

Self-neglect is a public health concern that can manifest as failure to provide oneself adequate food, water, clothing, shelter, personal hygiene, medication or safety precautions. This paper sought to inform federal policy and research priorities regarding effective strategies to detect, prevent and address self-neglect. This study aims to inform federal policy and research priorities regarding effective strategies to detect, prevent, and address self-neglect.

Design/methodology/approach

The authors conducted a rapid review of self-neglect literature and interviews with five national subject matter experts to inform federal policy and research priorities.

Findings

This study identified gaps in the literature and several approaches and numerous challenges to preventing, identifying and addressing self-neglect. The lack of a nationally accepted definition of self-neglect, a dearth of longitudinal studies which has limited research on self-neglect etiology and trends, and limited development and validation of screening tools, are among the challenges.

Research limitations/implications

Findings indicate that comparisons of self-neglect definitions, and longitudinal studies of self-neglect by subpopulations, are needed areas of future research. Issues for policy consideration include national self-neglect data collection and reporting requirements.

Originality/value

This study synthesizes recent literature on self-neglect, highlights gaps in the literature on self-neglect and points toward federal policy priorities for advancing effective strategies to detect, prevent and address self-neglect.

Details

The Journal of Adult Protection, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 2 December 2020

Stephen Martineau

The paper examines three English research papers on self-neglect, from 1957, 1966 and 1975, discussing them in the context of more recent thinking and the statutory…

Abstract

Purpose

The paper examines three English research papers on self-neglect, from 1957, 1966 and 1975, discussing them in the context of more recent thinking and the statutory framework in England.

Design/methodology/approach

In reviewing the three research papers, developments and points of continuity in the field of self-neglect were identified and are discussed in this paper.

Findings

In light of the findings of the three articles, the present paper traces some of the classificatory refinements in this field that have taken place since the papers were published, notably in respect of hoarding and severe domestic squalor. Some of the difficulties in making judgements about behaviour thought to breach societal norms are described, and the challenges practitioners face in intervening in cases, particularly where the person concerned is refusing assistance, are examined.

Originality/value

By drawing on the historical research context, the paper contributes to our current understanding of the field of self-neglect.

Details

The Journal of Adult Protection, vol. 23 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 15 August 2011

Suzy Braye, David Orr and Michael Preston‐Shoot

The research reported here aims to scope the concept of selfneglect as it is explored in the literature and interpreted in practice by professionals involved in adult…

4124

Abstract

Purpose

The research reported here aims to scope the concept of selfneglect as it is explored in the literature and interpreted in practice by professionals involved in adult safeguarding.

Design/methodology/approach

The approach taken included a systematic search and thematic analysis of English‐language literature on selfneglect, workshops with UK‐based adult safeguarding leads and practitioners from social services, police and health services, and scrutiny of Safeguarding Adults Boards' documentation.

Findings

The concept of selfneglect 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 selfneglect turn. Intervention in selfneglect requires careful exploration in the context of principles of personalisation, choice, control, and empowerment that underpin policy in adult social care and safeguarding.

Research limitations/implications

As a conceptual scoping review, this study seeks to establish broad themes of use to practitioners working with selfneglect. 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.

Practical implications

Assessment in selfneglect 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.

Originality/value

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

Details

The Journal of Adult Protection, vol. 13 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 4 December 2019

Sanket Sunand Dash and Lalatendu Kesari Jena

The purpose of this paper is to define workplace victimization as any behavior that impairs employees’ basic psychological needs and explores the mutually interactive…

Abstract

Purpose

The purpose of this paper is to define workplace victimization as any behavior that impairs employees’ basic psychological needs and explores the mutually interactive association between trait self-deception; emotional neglect, especially by supervisors, and workplace victimization.

Design/methodology/approach

Workplace victimization is identified as a pervasive problem in organization. This paper zeroes in on self-deception and emotional neglect as two possible antecedents of workplace victimization, explores the genesis of the two concepts and analyzes their conceptual relationship with each other and with workplace victimization. Based on the conceptual analysis, it identifies the lack of intentionality as a common element in both constructs and identifies a set of possible frameworks linking self-deception, emotional neglect and workplace victimization for future research.

Findings

This paper explores four possible frameworks to model the expected association while advocating for investigation of these given models to check whether one has considerable expository success than other by either connecting or disassociating these two constructs.

Research limitations/implications

The amount of linkage between self-deception and emotional neglect at workplace is worth investigating, and this research paper presents several possible models that might help to focus and organize the future workplace investigations.

Practical implications

The current paper postulates that supervisors’ and subordinates’ ability to display appropriate leadership and follower behavior and interaction will be impaired if they are high in trait self-deception and have been the victim or perpetrators of emotional neglect.

Originality/value

In the workplace, self-deceptive individuals display behaviors such as conscientiousness, resilience, optimism and competitiveness that are considered characteristics of good employees and, hence, are more likely to be promoted to supervisory positions, where emotional neglect of others such as subordinates becomes more pertinent.

Details

International Journal of Workplace Health Management, vol. 13 no. 1
Type: Research Article
ISSN: 1753-8351

Keywords

Article
Publication date: 9 February 2015

Suzy Braye, David Orr and Michael Preston-Shoot

– The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect.

3125

Abstract

Purpose

The purpose of this paper is to report the findings from research into 40 serious case reviews (SCRs) involving adults who self-neglect.

Design/methodology/approach

The study comprised analysis of 40 SCRs where self-neglect featured. The reviews were found through detailed searching of Local Safeguarding Adult Board (LSAB) web sites and through contacts with Board managers and independent chairs. A four layer analysis is presented of the characteristics of each case and SCR, of the recommendations and of the emerging themes. Learning for service improvement is presented thematically, focusing on the adult and their immediate context, the team around the adult, the organisations around the team and the Local Safeguarding Board around the organisations.

Findings

There is no one typical presentation of self-neglect; cases vary in terms of age, household composition, lack of self-care, lack of care of one's environment and/or refusal to engage. Recommendations foreground LSABs, adult social care and unspecified agencies, and focus on staff support, procedures and the components of best practice and effective SCRs. Reports emphasise the importance of a person-centred approach, within the context of ongoing assessment of mental capacity and risk, with agencies sharing information and working closely together, supported by management and supervision, and practising within detailed procedural guidance.

Research limitations/implications

There is no national database of SCRs commissioned by LSABs and currently there is no requirement to publish the outcomes of such inquiries. It may be that there are further SCRs, or other forms of inquiry, that have been commissioned by Boards but not publicised. This limits the learning that has been available for service improvement.

Practical implications

The paper identifies practice, management and organisational issues that should be considered when working with adults who self-neglect. These cases are often complex and stressful for those involved. The thematic analysis adds to the evidence-base of how best to approach engagement with adults who self-neglect and to engage the multi-agency network in assessing and managing risk and mental capacity.

Originality/value

The paper offers the first formal evaluation of SCRs that focus on adults who self-neglect. The analysis of the findings and the recommendations from the investigations into the 40 cases adds to the evidence-base for effective practice with adults who self-neglect.

Details

The Journal of Adult Protection, vol. 17 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 13 June 2016

Michael Preston-Shoot

The purpose of this paper is to draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of…

1768

Abstract

Purpose

The purpose of this paper is to draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of scrutiny, in order to understand how complex contexts impact on self-neglect work. It also updates the dataset of self-neglect SCRs and accompanying thematic analysis.

Design/methodology/approach

Psychodynamic and systemic ideas are applied to the content of published SCRs in order to understand how different contexts – societal, legal, organisational, professional and personal – impact on and are influenced by work with adults who self-neglect. Further published reviews are added to the core dataset, with thematic analysis updated using four domains.

Findings

Thematic analysis within and recommendations from SCRs have focused on the micro context, what takes place between individual practitioners, their teams and adults who self-neglect. This level of analysis also commonly extends to how organisations have worked together and how Local Safeguarding Adults Board (LSABs) have supported and scrutinised their collaboration. This level of analysis enables an understanding of local geography. However, there are wider systems that impact on and influence this work, especially law and the societal context. If review findings and recommendations are to fully answer the question why, systemic analysis should be extended to appreciate the influence of national geography.

Research limitations/implications

There is still no national database of reviews commissioned by LSABs so the dataset reported here might be incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in LSAB annual reports. This makes learning for service improvement challenging.

Practical implications

Answering the question why is a significant challenge for safeguarding adults reviews (SARs). Different approaches have been recommended, some rooted in systems theory. The theoretical formulations here extend the lens of systemic analysis on the different contexts that influence how practitioners work with adults who self-neglect and simultaneously are shaped by that work. This adds to the practice, management and organisational evidence base for working with adults who self-neglect but also shines the analytic lens on legal and policy mandates.

Originality/value

The paper extends the use of systemic theory for understanding and learning from practice with adults who self-neglect and additionally offers psychodynamic formulations to appreciate what happens within and between practitioners and their organisations. The paper therefore contributes new perspectives to the methodology for conducting SARs. It also extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further building on the evidence base for practice.

Details

The Journal of Adult Protection, vol. 18 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 9 July 2021

Michael Preston-Shoot

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. It also explores whether…

Abstract

Purpose

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. It also explores whether lessons are being learned from the findings and recommendations of an increasing number of reviews on self-neglect cases.

Design/methodology/approach

Further published reviews are added to the core data set, mainly drawn from the websites of safeguarding adults boards (SABs). Thematic analysis is updated using the domains used previously. The domains and the thematic analysis are grounded in the evidence-based model of good practice, reported in this journal previously.

Findings

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness and alcohol misuse are prominent. Some SABs are having to return to further cases of self-neglect to review, inviting scrutiny of what is (not) being learned from earlier findings and recommendations.

Research limitations/implications

The national database of reviews commissioned by SABs remains incomplete. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. National Health Service Digital annual data sets do not enable the identification of reviews by types of abuse and neglect. However, the first national analysis of SARs has found self-neglect to be the most prominent type of abuse and/or neglect reviewed. Drawing together the findings builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice.

Practical implications

Answering the question “why” remains a significant challenge for SARs. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question. Greater scrutiny is needed of the impact of the national legal, policy and financial context within which adult safeguarding is situated.

Originality/value

The paper extends the thematic analysis of available reviews that focus on study with adults who self-neglect, further reinforcing the evidence base for practice. Propositions are explored, concerned with whether learning is being maximised from the process of case review.

Details

The Journal of Adult Protection, vol. 23 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 15 September 2020

Michael Preston-Shoot

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to…

Abstract

Purpose

The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis and explore the degree to which SARs draw upon available research and learning from other completed reviews.

Design/methodology/approach

Further published reviews are added to the core data set, mainly drawn from the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the four domains used previously. The four domains and the thematic analysis are rounded in the evidence-based model of good practice, reported in this journal previously. Multiple exclusion homelessness and alcohol misuse are prominent in this sample of reviews.

Findings

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. Multiple exclusion homelessness emerges as a subset within this sample, demonstrating that SABs are engaging in reviews of people who die on the streets or in temporary accommodation.

Research limitations/implications

The national database of reviews commissioned by SABs remains incomplete and does not contain many of the SARs reported in this evolving data set. The Care Act 2014 does not require publication of reports but only a summary of findings and recommendations in SAB annual reports. NHS Digital annual data sets do not enable identification of reviews by types of abuse and neglect. It is possible, therefore, that this data set is also incomplete. Drawing together the findings from the reviews nonetheless builds on what is known about the components of effective practice, and effective policy and organisational arrangements for practice.

Practical implications

Answering the question “why” remains a significant challenge for safeguarding adult reviews. The findings confirm the relevance of the evidence-base for effective practice but SARs are limited in their analysis of what enables and what obstructs the components of best practice. Greater explicit use of research and other published SARs might assist with answering the “why” question, drawing attention where appropriate to policies being pursued by the central government that undermine any initiative to end rough sleeping.

Originality/value

This paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence-base for practice. The evidence-base also supports practice with individuals who experience multiple exclusion homelessness. Policymakers and practitioners have an approach to follow in this complex, challenging and demanding area of practice.

Details

The Journal of Adult Protection, vol. 22 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 13 April 2015

Suzy Braye, David Orr and Michael Preston-Shoot

The purpose of this paper is to analyse in detail the findings from 40 serious case reviews (SCRs) involving adults who self-neglect, and to consider the commissioning and…

1873

Abstract

Purpose

The purpose of this paper is to analyse in detail the findings from 40 serious case reviews (SCRs) involving adults who self-neglect, and to consider the commissioning and reporting of such inquiries in the context of accountability that also involves the Coroner and the Local Government Ombudsman.

Design/methodology/approach

This study comprised a cross-case analysis of 32 SCRs, using a four-layer design of the adult and their living context, the team around the adult, the organisations around the team, and the Local Safeguarding Board around the organisations.

Findings

Available reports tend towards description of events rather than appraisal of what influenced practice. They highlight the challenges in cases of self-neglect practice, including person-centred approaches, capacity assessment and securing engagement. Familiar themes emerge when the spotlight turns to professional and organisational networks, namely information-sharing, supervision, recording and compliance with procedures and legal rules. Some Local Safeguarding Adults Boards found the process of conducting and then using serious case reviews for service improvement challenging.

Research limitations/implications

The cross-case approach to thematic analysis focuses on reports into situations where outcomes of professional and organisational intervention had been disappointing. Nonetheless, the themes derived from this analysis are similar to other research findings on what represents best practice when working with cases involving self-neglect.

Practical implications

The paper identifies learning for the effective commissioning and conduct of SCRs, and for service improvement with respect to practice with adults who self-neglect.

Originality/value

The paper offers further detailed analysis of a large sample of SCRs that builds the evidence-base for effective practice with adults who self-neglect and for efficient management of process of commissioning and conducting SCRs.

Details

The Journal of Adult Protection, vol. 17 no. 2
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 15 September 2020

Stephen Martineau and Jill Manthorpe

This paper presents the results of a thematic analysis of safeguarding adults reviews (SARs) where homelessness was a factor to illuminate and improve safeguarding…

Abstract

Purpose

This paper presents the results of a thematic analysis of safeguarding adults reviews (SARs) where homelessness was a factor to illuminate and improve safeguarding practice and the support of adults who are homeless in England.

Design/methodology/approach

SARs were identified from a variety of sources and a thematic analysis was undertaken using data extraction tables.

Findings

In addition to identifying shortcomings in inter-agency co-operation, SARs highlighted a failure to recognize care needs and self-neglect among people with experience of homelessness and evidenced difficulties in engagement between professionals and people with experience of homelessness.

Research limitations/implications

The authors may have failed to find some SARs in this category (there is no central registry). SARs vary in quality and in detail; some were not full reports. The approach to people’s experience of homelessness was broad and covered more than the circumstances of people who were rough sleeping or living on the streets.

Originality/value

This paper contributes to the current practice debates and policy initiatives in respect of homelessness and safeguarding in England. It may have wider relevance in the rest of the UK and internationally.

Details

The Journal of Adult Protection, vol. 22 no. 4
Type: Research Article
ISSN: 1466-8203

Keywords

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