Lindsey, I respect your advice, which is usually on the money. But you missed the boat when you advised the accountant to accompany the hygenically-challenged employee to her home to witness her cleaning herself up. You don't know her state of mind -- she certainly is depressed -- and she may have other issues. If the accountant is a man, this may add a threatening or unnecessary dimension and may further embarrass or alienate the employee, and it may leave him vulnerable to sexual harassment charges or worse. I think the accountant should ask the employee who she wants to help her (a family member or friend), then they all should sit down and talk and visit the employee's home, etc. The friend/family member should be an ally. And, the accountant might suggest low-cost counseling and offer to pay for part of it.