A survey has found 233 "eccentric vulnerable adults" in the greater Dublin area. It warns that it may be necessary to "limit" their freedom of choice when the risks they pose, such as creating a fire hazard, causes public concern. It also says they should be put on an at-risk register.
Poor personal hygiene, suspiciousness, secrecy and hoarding are among the traits of a majority of the people identified in the survey funded by the Eastern Health Board.
But although their living conditions in two-thirds of cases are described as "atrocious" or "dirty", most appear to be in good or fair health.
The report acknowledges that all its information on the people concerned is obtained from third parties. There is little possibility that they themselves would open the door to researchers.
Case histories outlined in the report include:
A couple who have barred all their doors and windows and who never answer the door. Nobody has been inside the house and nobody has any idea how they survive. Every few weeks a van delivers furniture. Neighbours fear they are burning this furniture in the house.
A woman whose front door will not open fully because of the amount of rubbish stored in the hallway. Her kitchen is filthy except for one corner of the table which holds a clean cup, plate, knife and fork. She is verbally aggressive towards her neighbours and has little contact with them.
A man who lives with two dogs and five cats which are seldom let out of the house. The smell is overpowering. He suffers from ulcers and general ill-health. He seldom allows public health nurses into the house.
Nearly half the people in the survey live in accommodation which they own themselves.
Only one-third have a history of alcohol abuse. Just over half are women. Most have no family support, the report notes, but this is often because they have no family or have no wish for contact with their families.
Among professionals, public health nurses are the ones who are most likely to be let in.
"Over one-third of individuals' houses or flats were considered to pose a fire hazard, due primarily to the individuals' tendency to hoard anything from papers and rubbish to furniture," says the report. "Unsafe storing of this rubbish and furniture near cooking and heating facilities also caused concern.
"While it is accepted that individuals have a civil right to live as they choose, it may be necessary to limit this freedom of choice when their lifestyle and environment is a cause of public concern," it says.
"Where necessary legislation should be enacted to provide a framework for emergency intervention," it adds later.
It also suggests that the social services can find out what is happening to such people by staying in touch with family, friends, neighbours and shopkeepers.
Professionals should hold a case conference when they find out about such a person and appoint a "key worker", defined as "the person most likely to be acceptable to the client.".
The survey was unable to throw any light on why these people live the way they do.
The authors of the report say some people who display odd, unconventional behaviour have a treatable psychiatric condition and others have an untreatable personality disorder.
They conducted the survey by contacting voluntary and statutory organisations which might be in touch with eccentric adults.
Because of issues of confidentiality and because some organisations object to the use of the term "eccentric", the survey may have failed to identify all such people in the greater Dublin area, the report acknowledges.