people lives communitiesSlide 001 people lives communities

Vile Bodies: understanding the neglect of personal

hygiene in a sterile society

Peter Bates

peter.bates@ndti.org.uk Tel 07710 439 677

people lives communities

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Slide 560

people lives communities

Dimensions of self-neglect

Domestic squalorDirt

Hoarding

Administration

Service

refusalTreatment

Help

Personal

care Hygiene

Malnourishment

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Acknowledging our own response:

A sensory and emotional experience

Seeing, hearing, smelling, tasting, touching

The human disgust response

Bewildered, ineffective, unwanted and silenced

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Seeking meaning and explanations

A few places to start

1. Pleasure and preoccupation

2. Because you’re not worth it

3. Skills, knowledge and resources

4. Disability, health and wellbeing

5. Defiant rejection of conformity

6. Capacity, consequences and responsibility

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Twenty four viewpoints… and counting

Advertiser

Advocate

Animal Welfare

Behaviourist

Counsellor

Dentist

Dietician

Doctor

Environmental Health

Finance Advisor

Fire Officer

Geneticist

Historian

Landlord

Lawyer

Occupational Therapist

Pharmacist

Psychoanalyst

Psychologist

Public health

Risk manager

Social Worker

Speech therapist

Teacher

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Twenty five laws… and counting

1936 Public Health

1948 National Assistance

1949 Prevention of Damage by Pests

1968 Health Services & Public Health

1970 Chronically Sick & Disabled

Persons

1974 Health and Safety at Work

1977 Homeless Persons

1984 Police and Criminal Evidence

1984 Public Health

1989 Children

1990 Environmental Protection

1990 NHS and Community Care

1998 Housing

1998 Human Rights

2000 No Secrets

2000 Care Standards

2002 Homelessness

2003 Antisocial Behaviour

2004 Housing

2005 Clean Neighbourhoods

2005 Mental Capacity

2006 Animal Welfare

2007 Mental Health

2010 Equalities

2014 Care

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Assessment tools

Environmental Cleanliness and Clutter Scale

Impact of Squalor Checklist

Self Neglect Severity Scale

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Part of the New South Wales scale

0 1 2 3

SKIN Neat and

clean

Mildly or

slightly dirty

Moderately dirty,

flaking or greasy

skin

Filthy, peeling skin, old dry flaking

skin, exposed sores, infestation

HAIR Neat and

clean

Mildly dirty:

untidy, uncut

uncombed

Moderately dirty:

greasy, overgrown,

uncombed

Filthy: overgrown, extremely dirty,

matted, infested

FINGER

NAILS

Neat and

clean

Mildly dirty,

ragged

Moderately dirty:

nails poorly kept,

long, dirty, nicotine

stained

Filthy: grossly overgrown, ground

in dirt, very nicotine stained

CLOTHING Neat and

clean

Mildly dirty or

untidy:

unironed and

dirty

Moderately dirty:

some stains, mildly

malodorous

Filthy: many stains and badly

needing washing, may have

cigarette burns, excrement, very

malodorous

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Dental care

Do you have a

toothbrush?

How often do you clean

your teeth?

How often should you

clean your teeth?

Do you have dentures?

Are you registered with

a dentist?

When did you last see a

dentist?

If you saw a dentist

within the last year,

what was the

appointment for?

If it is more than one

year since you saw a

dentist, why have you

not been in the last

year?

What would make you

go to see a dentist?

Why might oral hygiene

be important to you?Khakhar et al 2011

Visitors notice neglect

Broken skin or infestation

Neighbours complain

Other services withdraw

Children at risk

Threats of violence

towards staff

Utilities disconnected

Death

likely

Tell line manager

Use environmental

health powers

Serious

case review

Evict

Prosecute

Case

conference

Response

Stimulus

Refusing

access

Safeguarding

referral

people lives communitiespeople lives communities

Resources at www.peterbates.org.uk/Subject-index

Scroll down to the paragraph ‘Self neglect’

Peter Bates

peter.bates@ndti.org.uk; Tel 07710 439 677