Self Neglect & Hoarding


Self-neglect is any failure of an adult to take care of himself or herself that causes, or is reasonably likely to cause within a short period of time, serious physical, mental or emotional harm or substantial damage to or loss of assets.

Self-neglect can happen as a result of an individual’s choice of lifestyle, or the person may

  • be depressed,
  • have poor health,
  • have cognitive (memory or decision making) problems, or
  • be physically unable to care for self.

Self-neglect includes:

  • Living in grossly unsanitary conditions
  • Suffering from an untreated illness, disease or injury
  • Suffering from malnutrition to such an extent that, without an intervention, the adult’s physical or mental health is likely to be severely impaired.
  • Creating a hazardous situation that will likely cause serious physical harm to the adult or others or cause substantial damage to or loss of assets, and
  • Suffering from an illness, disease or injury that results in the adult dealing with his or her assets in a manner that is likely to cause substantial damage to or loss of the assets.­­

Related Articles:

Dismissing Self-Neglect:

Elsie’s Story:


“The Hoarding Protocol sets out a framework for social care and other relevant agencies to work in partnership using an outcome focused, solution based model. The protocol offers clear guidance to staff working with hoarders.”

Hoarding is considered to be a significant problem when:

  • the amount of clutter in the person’s home is increasing
  • they bring in more things each day and discard very little
  • the amount of clutter interferes with everyday living – for example, they are unable to use the kitchen or bathroom and cannot access rooms

People with hoarding difficulties often experience obsessive compulsive disorder (OCD), which may or may not be directly connected to their clutter problem. Hoarding is also often associated with anxiety and depression.

Compulsive hoarding is challenging to treat because many people who hoard don’t see it as a problem, or have little awareness of their disorder and how it’s impacting on their life.

However, it’s really important to encourage a hoarder to seek help, as their obsession can not only cause loneliness and mental health problems, but poses a health and safety risk, too. If not tackled, it is a problem that will most likely never go away.

What causes hoarding?

The reasons why someone becomes a hoarder are still not fully understood. However, the problem tends to persist because:

  • the person finds it difficult to discard things
  • they may have problems with order, organisation and decision-making
  • they acquire more things than they throw away

The person will also have unhelpful beliefs, such as:

  • I may need this some day
  • If I throw this away, I won’t be able to cope with the feelings of loss
  • If I buy this, it will make me happy

Attempts to discard things often bring up very strong emotions that can feel overwhelming, so the hoarder tends to put off or avoid making decisions about what can be thrown out.

Often, many of the things kept are of little or no monetary value, and may be what most people would consider rubbish. The person may acquire several of the same items because they are unable to find what they need, or they may have stockpiled food or clothes “just in case”.

A person is more likely to become a compulsive hoarder if:

  • there is a family history of hoarding
  • they have experienced deprivation
  • they grew up in a cluttered home
  • they have another mental health condition, such as anxiety, depression or social phobia (a fear of social occasions)
  • they are struggling to cope with a stressful life event, such as the death of a loved one
  • they have a history of alcohol dependence
  • they are lonely (hoarding brings comfort)

Symptoms of hoarding

A compulsive hoarder typically:

  • may keep or collect items that are of no value, like junk mail and carrier bags, or items they intend to re-use or repair
    finds it hard to throw anything away, and just moves items from one pile to another
  • finds it hard to categorise or organise items
  • has difficulties making decisions and struggles to manage everyday tasks, such as cooking, cleaning and paying bills
  • becomes obsessively attached to items, refusing to let anyone touch or borrow them
  • does not socialise with other people

Some studies suggest that hoarding often starts in the teenage years (as early as 13 or 14), where broken toys or school papers may be collected. The hoarding then becomes worse with age.

Why might compulsive hoarding be a problem?

Compulsive hoarding is a problem for several reasons.

Because of the amount of clutter, the person may not be able to use the rooms in their house for their intended purpose, or even be able to sit in a chair without having to move things.

In extreme cases the piles of clutter can become a fire risk, and can result in the hoarder tripping and falling. And because the home is virtually impossible to clean, living conditions tend to be very unhygienic and can lead to rodent or insect infestations, blocked drains and other problems that may also affect neighbouring properties.

The hoarder is usually reluctant or unable to have visitors, or even allow tradesmen in to carry out essential repairs.

They quickly become isolated and lonely and are often prone to anxiety and depression. The hoarding probably brings them comfort, but deep down they are unhappy.

They may ignore the pleas of family and friends to get help, as they do not see it as a problem or cannot bring themselves to tackle it.

The hoarding literally takes over the person’s life, causing their work performance, personal hygiene and social life to suffer.

Case Studies:

The Rise of Hoarding:

My Mother – The compulsive Hoarder:

The Hoarder who can’t get into his own house:

North Wales Self Neglect Protocol V2

Hoarding Protocol