Social care responses to self-neglect and hoarding among older people: What works in practice?
Aims
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.
Funding
NIHR School for Social Care Research (Research Project P156)
Methods
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
- Current thinking on hoarding behaviour (webinar, 28 November 2022).
- Showcase of social care research in NIHR Policy Research Units (22 March 2023)
Publications
Our final report is currently under review
Reports
Steils, N., Woolham, J., Manthorpe, J., Martineau, S., Owen, J., Stevens, M., & Tinelli, M. (2022) What do we know about hoarding behaviour and treatment approaches for older people? A thematic review, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. https://doi.org/10.18742/pub01-083
Martineau, S., Manthorpe, J., Woolham, J., Steils, N., Stevens, M., Owen, J., and Tinelli, M. (2021) Social care responses to self-neglect among older people: an evidence review of what works in practice, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London. https://doi.org/10.18742/pub01-047
Articles
Owen, J., Woolham, J., Manthorpe, J., Steils, N., Martineau, S., Stevens, M., Tinelli, M. (2022) Adult safeguarding managers' understandings of self-neglect and hoarding. Health & Social Care in the Community. https://doi.org/10.1111/hsc.13841
Manthorpe, J., Woolham, J., Steils, N., Stevens, M., Martineau, S., Owen, J., & Tinelli, M. (2022) Experiences of adult social work addressing self-neglect during the Covid-19 pandemic. Journal of Social Work. https://doi.org/10.1177/14680173221083446
Blog posts
Martineau, S. (2022) ‘…items and belongings…’ – a hoarding case at the Court of Protection, (blog post), Health & Social Care Workforce, 27 September.
Martineau, S. (2022) On best interests: values and participation in mental capacity law, (blog post), Health & Social Care Workforce, 26 June.
Conferences
Owen, J., Manthorpe, J., Steils, N., Woolham, J., Martineau, S., Stevens, M., & Tinelli, M. (2022) Social care responses to self-neglect and hoarding among older people: Emerging findings of what works in practice. Annual Conference of the British Society of Gerontology 2022, Bristol/online, 8th July.
Presentation to GPs and Practice Managers in London, 20th January 2022.
We have made a number of presentations of our findings in those sites which took part in our study.
News
Presentation on working with people with hoarding behaviour at Community of Enquiry workshop
The event was organised and facilitated by Social Care Wales

Reporting findings of the self-neglect and hoarding behaviour among older people study
Nicole Steils and Michela Tinelli were at the 5 Five Nations Conference Series

Showcasing King's work on self-neglect
Nicole Steils and Jess Harris discussed two recent research projects on the topic

Self-neglect and hoarding behaviour among older people study
Nicole Steils and Michela Tinelli were feeding back study findings to participants

Reporting findings from Unit self-neglect and hoarding study back to participants
Nicole Steils presented findings from our NIHR School for Social Care Research funded study

Current thinking on hoarding behaviour
Over 320 people attended a webinar focusing on psychological and legal perspectives

King's researchers facilitated two workshops on self-neglect and hoarding behaviour in Greenwich
Nicole Steils and Jen Owen were sharing findings from a NIHR School for Social Care Research study

Self-neglect, hoarding behaviour and the Fire & Rescue Service
Nicole Steils and Michela Tinelli (LSE) discussed harm prevention, services, and costs

Self-neglect and hoarding behaviour study reports back to study site
Nicole Steils discusses findings with Safeguarding Adults Board

What do we know about hoarding behaviour and treatment approaches for older people?
New evidence review from our NIHR School for Social Care Research study

Self-neglect among older people: an evidence review
How should Adult Social Care best respond?

Publications
Our final report is currently under review
Reports
Steils, N., Woolham, J., Manthorpe, J., Martineau, S., Owen, J., Stevens, M., & Tinelli, M. (2022) What do we know about hoarding behaviour and treatment approaches for older people? A thematic review, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. https://doi.org/10.18742/pub01-083
Martineau, S., Manthorpe, J., Woolham, J., Steils, N., Stevens, M., Owen, J., and Tinelli, M. (2021) Social care responses to self-neglect among older people: an evidence review of what works in practice, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London. https://doi.org/10.18742/pub01-047
Articles
Owen, J., Woolham, J., Manthorpe, J., Steils, N., Martineau, S., Stevens, M., Tinelli, M. (2022) Adult safeguarding managers' understandings of self-neglect and hoarding. Health & Social Care in the Community. https://doi.org/10.1111/hsc.13841
Manthorpe, J., Woolham, J., Steils, N., Stevens, M., Martineau, S., Owen, J., & Tinelli, M. (2022) Experiences of adult social work addressing self-neglect during the Covid-19 pandemic. Journal of Social Work. https://doi.org/10.1177/14680173221083446
Blog posts
Martineau, S. (2022) ‘…items and belongings…’ – a hoarding case at the Court of Protection, (blog post), Health & Social Care Workforce, 27 September.
Martineau, S. (2022) On best interests: values and participation in mental capacity law, (blog post), Health & Social Care Workforce, 26 June.
Conferences
Owen, J., Manthorpe, J., Steils, N., Woolham, J., Martineau, S., Stevens, M., & Tinelli, M. (2022) Social care responses to self-neglect and hoarding among older people: Emerging findings of what works in practice. Annual Conference of the British Society of Gerontology 2022, Bristol/online, 8th July.
Presentation to GPs and Practice Managers in London, 20th January 2022.
We have made a number of presentations of our findings in those sites which took part in our study.
News
Presentation on working with people with hoarding behaviour at Community of Enquiry workshop
The event was organised and facilitated by Social Care Wales

Reporting findings of the self-neglect and hoarding behaviour among older people study
Nicole Steils and Michela Tinelli were at the 5 Five Nations Conference Series

Showcasing King's work on self-neglect
Nicole Steils and Jess Harris discussed two recent research projects on the topic

Self-neglect and hoarding behaviour among older people study
Nicole Steils and Michela Tinelli were feeding back study findings to participants

Reporting findings from Unit self-neglect and hoarding study back to participants
Nicole Steils presented findings from our NIHR School for Social Care Research funded study

Current thinking on hoarding behaviour
Over 320 people attended a webinar focusing on psychological and legal perspectives

King's researchers facilitated two workshops on self-neglect and hoarding behaviour in Greenwich
Nicole Steils and Jen Owen were sharing findings from a NIHR School for Social Care Research study

Self-neglect, hoarding behaviour and the Fire & Rescue Service
Nicole Steils and Michela Tinelli (LSE) discussed harm prevention, services, and costs

Self-neglect and hoarding behaviour study reports back to study site
Nicole Steils discusses findings with Safeguarding Adults Board

What do we know about hoarding behaviour and treatment approaches for older people?
New evidence review from our NIHR School for Social Care Research study

Self-neglect among older people: an evidence review
How should Adult Social Care best respond?

Our Partners

Principal Investigator
Nicole Steils
Research Fellow