Pam Laidman

Self-nelgect is a health and social care condition involving individuals, usually older adults, who, in some way, take insufficient care of themselves to an extent that is detrimental to their health. This condition takes a variety of forms including a lack of personal hygiene, poor nutrition and unmaintained home environments. Self-neglect is addressed under the Care Act 2014 within Safeguarding Adults through the application of specific sets of procedures which usually prioritise Mental Capacity Assessments. In practice, however, this condition presents a complexity of ethical dilemmas and challenegs which, whilst not unique within health and social care, come together in specific ways for self-neglect.

This thesis suggests that the problematic nature of self-neglect emerges from the legal, medical and conceptual framing employed. Despite their being underpinned by Human Rights concerns these frames lead to ageist, unjust and depersonalising practices based on pre-conceived moral assumptions and are detrimental to the individuals involved whose views are silenced.

This study constructs a thicker frame for self-neglect by starting with the views and understandings of individuals who self-neglect. It argues that both self-care and a lack of self-care are habitual activities that can change over time in response to physical and social experiences and as a consequence of decisions made, for some reasons, about other things. In this context the condition self-neglect becomes less about the individual's lack of capacity and capability to self-care, or stop self-neglecting. It becomes more about embodied beings constructed by their self-care and lack of self-care experiences who are positively coping with living a life. As such it offers the opportunity to identify different, less problematic approaches to self-neglect practice and intervention by health and social care practitioners