The Price We Pay

Recent events in my situation remind me that Diogenes Syndrome costs a lot. A person who's discovered in a state of self-neglect may have health problems ranging from the minor to the severe. They end up either in the mental health or the medical system, where they're evaluated, treated (often at taxpayer expense) and, because they're lucid and considered competent, sent back home where the cycle begins again. And again. Social services are helpless when an individual presents as competent -- even if their behavior says otherwise.
I had a conversation the other day with the social worker at the rehab center where my ex-sister-in-law is recovering from her third bout with MRSA. She told me frankly that in cases like this, where an individual appears competent and able to make their own decisions (even bad ones), the only option is to "allow her to fail" -- to come to crisis as a result of her own actions or lack thereof: the only scenario in which anybody can intervene.
We tend to believe (maybe because we want to believe) that individuals will act in their own best interest. If you get hungry enough, you'll eat your peas, as it were. But what's so hard to understand about Diogenes Syndrome is that this is not always the case. These individuals will ignore basic needs, let severe health problems go untreated, all the while insisting that everything is fine and demanding to be left alone. And so, leaving someone to the consequences of their own (bad) decisions is a tricky proposition that ultimately puts them back into the care of a system that is powerless to do anything more than treat the presenting symptom and release them to the same situation. It's this cycle that sets up the sufferer for more suffering and the community for more expenses from repeated care.