Spotting and responding to self-neglect

Can you tell if someone has not been looking after themselves? Is it because they have not showered or changed their clothes? Is it because they have lost weight or their appearance is markedly different? Or something more hidden you cannot see?

The route out of the lockdown is already complex with many of us having to make balanced decisions about going out to work and seeing family. What will the lockdown have done to us in the meantime? Will we look different to how people remember us – well maybe our hair will be longer if we have some, or if we have tried to cut it ourselves we may well look a bit odd!


So as we greet people we haven’t seen for two to three months what will we notice about them? Knowing them and their situations as we do, are there things we will be particularly looking out for? A jaunty demeanour replaced by withdrawal; a shining face turned to an unhealthy pallor; rings around the eyes or bruises; a physical condition got worse, or even maybe better if what was needed was an enforced good rest.

A London Safeguarding Adults Board reports a significant increase in April of referrals of vulnerable adults where self-neglect is a key factor. These have perhaps been acute examples but the modelled expectation is that as more people emerge and resume some degree of socially distanced public contact there will be a further spike in referrals as hidden concerns come to light.

Churches in due course, once risk assessments have been completed, may be one of those comfortable places which older people may feel they can venture towards. So when they do, pastoral teams would do well to take a careful look at what’s changed. It may not be like the children’s milestones we may have missed; the changes are probably likely to be far more subtle. We know to some extent that we are all changed in some way. But for those who perhaps live alone, or already had an underlying condition pre-lockdown that needed good self-care and vigilance, let’s keep focused and pass on any concerns to the minister or your church safeguarding officer.

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