Case studies
Case example: Jennifer
Jennifer is in her 70s and lives alone in her council owned property. Jennifer’s neighbour tells the housing officer she is worried that Jennifer may be self-neglecting.
Her flat has a lot of clutter, including papers and old clothes, and there is a strong smell coming from the property. Jennifer’s boiler is broken, and she has been using an electric heater to keep warm, kept close to her bedding; it is not clear how long this has been the case.
Jennifer is also spending a lot of time sat in one spot.
Interventions
Jennifer trusts her neighbour, and she plays an important role in helping Jennifer accept support from others.
The GP arranges an appointment for Jennifer to visit the surgery for a full health check.
London Fire Brigade support Jennifer by carrying out a Home Fire Safety visit and give Jennifer advice on using the electric heater, and install a smoke alarm.
Occupational Therapists arrange for delivery of equipment that will help Jennifer to mobilise.
The Housing Officer works with partners to create access for a maintenance officer to install a new boiler.
Jennifer agrees for her neighbour to help arrange for cleaner to help keep on top of home hygiene.
These actions show how different agencies play their role in responding to the concerns about Jennifer's possible self-neglect by offering her actionable, practical solutions and utilising existing relationships.
Case example: Eddie
Eddie is in his late 60s.
He has a range of physical health conditions, including diabetes, and previously suffered an acquired brain injury, believed to be linked to excessive alcohol use. He has a package of care in place to support with daily living, and has previously been known to mental health services.
The District Nurse who supports Eddie with his diabetes medication and wound management notices that Eddie is routinely ignoring advice and removing dressings, and that there are a number of empty alcohol bottles by his bed.
Interventions
The District Nurse raises their concerns with colleagues and requests a multi-agency meeting involving mental health services.
The social worker checks their system for more information about Eddie and finds he has a history of significant self-neglect. This informs the risk assessment.
The relevant agencies meet to discuss the risk and make an action plan in response to concerns.
Specialist input is sought around understanding Eddie’s acquired brain injury and the impact this may have on his decision making.
The GP arranges a joint visit with the District Nurse to carry out a mental capacity assessment, with consideration of executive functioning.
The Drug and Alcohol Wellbeing Service contact Eddie to offer support around his alcohol use.
These actions show how different agencies come together to discuss the known risks to Eddie and agree the next steps, with some example actions shown. This helps to share the risk and build a team around Eddie.