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Social care responses to self-neglect and hoarding among older people: What works in practice?


The overall aim of this exploratory study is to improve practice understanding of what works in responses to self-neglect and hoarding among older people.


NIHR School for Social Care Research (Research Project P156)


The study is using a mixed-methods approach. The literature and policy review phase involves: 1. Analysis of research literature on hoarding and self-neglect. 2. Review of national and local policy on hoarding and self-neglect. 3. Review of published literature on the perceptions/experiences of practitioners and of service users/those with personal experience/clients of hoarding and self-neglect. We will also conduct an analysis of Safeguarding Adults Reviews in this field.

Working with six sites in England, we are conducting interviews with safeguarding managers, practitioners and service users and family members. Finally, Michela Tinelli (LSE) is leading on an exploratory evaluation of the economic impact of self-neglect and hoarding among older people.

We are working with Age UK London on this project.

Ethics approval for this project

NHS Health Research Authority, West Midlands - Coventry & Warwickshire Research Ethics Committee Ref: 21/WM/0109

Note on research team

Nicole Steils replaced John Woolham as co-Principal Investigator of this project on 1 January 2022. John was co-Principal Investigator from the project's inception until his retirement at the end of 2021. John became a Visiting Senior Research Fellow at King's in February 2022. 

Martin Stevens was a member of the research team until his death in March 2022.

Summary of findings

Findings from the early phases of the project have been published in two reports and two articles (see under Outputs below). We are in the dissemination phase of the study. The final report is currently under review.

Related work in adult safeguarding

See also the Unit's parallel project: Opening the "too difficult box": Strengthening adult safeguarding responses to homelessness and self-neglect.

Other related studies

  • Decluttering the homes of people with hoarding behaviours: Local authority commissioning, professional practices, and user experiences (Project page)
  • Understanding and improving training offers for professionals working with people with hoarding behaviours (Project page)

And see

Half-day event

1 February 2024: New Perspectives on Hoarding Behaviours... from Psychology, Law & Social Care


Our Partners


NIHR School for Social Care Research

Project status: Completed

Principal Investigator