Self-neglect is characterised by an inability to meet one’s own basic needs and can be intentional or unintentional. Ageing populations, chronic illness, disability and poverty place individuals at risk for self-neglect. Self-neglect accounted for one-fifth of referrals received by the Elder Abuse Services (EAS) in 2008 in Ireland. Self-neglect (SN) can occur across the lifespan and is a serious public health issue and a social problem that is difficult to detect and diagnose. This article reports findings from a qualitative exploratory study, which explored the views and experience of a purposeful sample of seven Senior Case Workers (SCWs), working in Elder Abuse Services (EAS) on SN in Ireland. Individual interviews were tape recorded, transcribed and thematically analysed. Four major themes emerged from the findings: self-neglect as an entity, assessment, interventions and ethical challenges. SCWs are challenged and frustrated by this complex multidimensional phenomenon. Furthermore, poor operational definitions of ‘exceptional circumstances’ and ‘self-neglect’ can lead to diversity in choosing and responding to self-neglect. Suggestions are made about ways in which practice, policy and research can be developed.