vile bodies: understanding the neglect of personal hygiene ... · clean your teeth? do you have...
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people lives communitiesSlide 001 people lives communities
Vile Bodies: understanding the neglect of personal
hygiene in a sterile society
Peter Bates
[email protected] 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
[email protected]; Tel 07710 439 677