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Dad and Autistic Son Discovered in Worst Ever Case of Self-Neglect After Death of Mum

Social workers said the house was “uninhabitable” with urine and faecal stained carpets and mattresses, a fire risk because of clutter and had mould on the walls and no working oven

BBC 7 JUN 2022

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Social workers found a dad and his autistic son in the 'worst ever case of self-neglect' after the death of the man's mum.

Decade-old food was found in the fridge and bedding which had never been changed were found by authorities after the man was taken to Southmead Hospital A&E in Bristol when he had a fall.

The man was in a "significantly malnourished" state after North Bristol NHS Trust's safeguarding team raised an alarm and social services visited the pair's home, Bristol Live reported.

One experienced social worker described the case as one of the worst cases of self neglect he had ever seen.

Trust board members heard the house was “uninhabitable” with urine and faecal stained carpets and mattresses, a fire risk because of clutter and had mould on the walls and no working oven.

North Bristol Trust mental health liaison specialist practitioner Gayna Scott-Angell told the meeting: “The son reported he had never eaten hot food in his life, he was living off cereal, milk and canned drinks.

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North Bristol NHS Trust's safeguarding raised the alarm and social services visited the pair's home.

"This wasn’t in connection to his diagnosis of autistic spectrum disorder.

“Since the death of his mother, none of the bedding in the house had been changed. The son had not bathed or washed, none of his clothes had been washed, and his hair and nails had not been washed or cut.

“His clothes were all threadbare and his shoes all broken. The social worker stated that he had never seen such a level of self neglect in his career.”

The case was raised to the board on May 26 to demonstrate the safeguarding team’s good practice and the lessons learned.

Thankfully, the case has a happy ending as Ms Scott-Angell said: “With assistance from family friends and social services, the house was cleared of all its clutter.

"It was cleaned and repaired, with new mattresses, bedding, washing machine and oven put in.

“The son was prompted to attend to his personal hygiene, he was taken to the barber’s and went shopping for new clothes and shoes.”

One experienced social worker described the case as one of the worst cases of self neglect he had ever seen.

Ms Scott-Angell said the dad was diagnosed with cognitive impairment so could not give his son the prompting and support needed.

However, neither the dad or the friend, who took a week off work to support the son when the father first went into hospital, realised they required help or knew how to ask for it.

Ms Scott-Angell said a local authority support worker was appointed and took the son out for lunch.

She said: “So he was trying new foods which he was really excited about – he really enjoyed a McDonald’s – and he has expressed an interest in going to college.

“He was really excited about his opportunities. The son was really relieved and grateful to be getting support and help. The son had been wanting help but didn’t know how to access anything.”

She admitted it took some time for the team to realise just how urgently this was required because the father, who was taken by ambulance to the emergency department nine days after a fall left him with reduced mobility, had said his son would be fine at home alone.

Members heard the dad had several pressure injuries and was “extremely frail for a man his age”, so paramedics and A&E staff raised concerns about self neglect.

Ms Scott-Angell said: “He reported that since his wife sadly passed several years ago, the two of them shared the household chores, with the son doing the grocery shopping while he did the cooking and cleaning."

However, a needs assessment in hospital revealed he had struggled with mental health during the pandemic and was anxious and depressed.

He had lost a lot of weight and felt physically sick at the thought of eating, and that he was using alcohol to cope.

NBT board chairwoman Michele Romaine said: “I’m just sitting here struck by what would have happened if he hadn’t come into hospital, which is what makes me feel sad, powerless, but at least when they do, we are doing the things that we need to do, which is really good to know.”

Chief nursing officer Steve Hams said the two men’s outcomes were significantly better because of the team’s “professional curiosity” about how patients appear when they arrive at hospital.