self-neglect covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. It should be noted that self-neglect may not prompt a section 42 enquiry. An assessment should be made on a case by case basis. A decision on whether a response is required under safeguarding will depend on the adult’s ability to protect themselves by controlling their own behaviour. There may come a point when they are no longer able to do this, without external support.
Care and support statutory guidance
Hoarding is the excessive collection and storing of items, often in a chaotic manner, to the point where their living space is not able to be used for its intended purpose.
Hoarding is considered a significant problem if:
- the amount of clutter interferes with everyday living – for example, the person is unable to use their kitchen or bathroom and cannot access rooms
- the clutter is causing significant distress or negatively affecting the quality of life of the person or their family
A person with a hoarding disorder may have significant difficulty in discarding or parting with possessions. They may experience distress at the thought of getting rid of items or simply be unable, either physically or through other health-related factors, to get rid of things despite acknowledging that changes need to be made. The items can be of little or no financial value.
Hoarding is considered a standalone mental health disorder, however, it can also be a symptom of other medical disorders. It is not a lifestyle choice and hoarding must always be treated as a sign of vulnerability.
There are typically three types of hoarding:
- Compulsive Hoarding
- Bibliomania
- Animal Hoarding
Compulsive hoarding – this could consist of one type of object or collection of a mixture of objects, such as old clothes, newspapers, food, containers, human waste or papers. This will often manifest from an emotional attachment to inanimate items creating conflict in disposal
Bibliomania – books and written information, such as newspapers, magazines and articles, as well as DVDs and videos. It can also include ‘data hoarding’, which is the excessive storage and reluctance to delete electronic material which is no longer of use – such as computers, electronic storage devices, copies of emails, and other information in an electronic format.
Animal hoarding – this is often accompanied with the inability to provide minimal standards of care. The person may be unable to recognise that the animals are at risk. The homes of animal hoarders are often eventually destroyed by the accumulation of animal faeces and infestation by pests.
Someone who hoards may exhibit the following behaviour:
- Inability to throw things away
- Severe anxiety when attempting to discard items
- Indecision about where to put things or what to keep
- Distress, such as feeling overwhelmed or embarrassed about their possessions
- Suspicion of other people touching items
- Obsessive thoughts and actions: fear of running out of an items or of needing it for the future
- Functional impairments such as the loss of living space, becoming isolated from family and friends, financial difficulties, health hazards in the home
Resources
Hoarding Risk Assessment Tool
Clutter Index Rating (CIR) Tool
Guidance
Multi-agency Protocol for Working with People with Hoarding Behaviours
ADASS Self-Neglect and Hoarding
Multi-Agency Safeguarding Training
The Cambridgeshire and Peterborough Safeguarding Partnership Board delivers ‘Hoarding and Safeguarding Adults’ training
The aims of the course are to:
- Explore the benefits of a multi-agency approach to hoarding
- Identify resources to help practitioners to support someone who hoards
- Discuss when to consider raising hoarding as an adult safeguarding concern
Visit Multi-Agency Safeguarding Training for more details and instructions on how to book a place