Community on board to help hoarders

Is the mess in and around your home clutter, first-degree squalor or full on hoarding?

For professionals in safety and healthcare fields, it can be tough to determine the line between extreme clutter and hoarding but when health and safety are at risk, local organizations are working together to help.

The Prince Edward County Fire Department and the relatively new Hoarding Coalition hosted an information and training day last week for landlords, front-line workers, property supervisors and others who would support or interact with people living with hoarding.

Hoarding is acquiring and failing to dispose of a large number of items that appear to have little or no value. Mike Branscombe, fire prevention officer, says the most common items hoarded are papers, especially newspapers; items used every day that don’t get put away; clothing, plastic bags and recycling materials; sentimental and mechanical things.

Branscombe’s concern is fire safety and prevention.

“You have to think about the firefighters, the police and the emergency crews that might have to go into a hoarder’s home,” he said. “There’s often a threat to life for these people and for the person or people living in the home. There’s often stairways blocked and no way to escape safely, there might be heat sources running near combustibles and there’s usually a pile of extension cords involved.”

Hoarding also creates dangerous situations for firefighters and first responders during emergency situations, including structural failure, increased smoke and spread of fire.

“A firefighter only has a few minutes to save the life and get out of there before the person dies from smoke inhalation,” he said.

Acting on complaints received at the fire department, Branscombe has worked with the Hoarding Coalition three times over the past year in the County.

“I have seen serious situations here in the County and because of the level of hoarding there was threat to life and you have to follow the law, but you also have to show compassion. We can do anything required to remove the threat to life and make sure safety devices are installed, but we also need to bring in others who are trained to assist.”

The Hoarding Coalition has grown to include personal support workers, social workers and other front-line people.

Sandie Sidsworth, executive director of the Hastings and Prince Edward Branch of the Canadian Mental Health Association, was also a speaker at the training session.

“There is a difference between stockpiling and hoarding. Today we know that behaviours are often triggered by a loss and grief work is often necessary,” she said. “There are resources in places for people dealing with hoarding, including counselling, organized clean-up, support and most important, is aftercare.”

“Hoarding is not caused by a lack of responsibility or laziness,” she explained. “Mental health workers work from the perspective that a large majority of these individuals have one or more mental health disorders and hoarding behaviours can often stem from loss or trauma.”

Clutter image ratings 1-4, not so much of a concern; levels 5-9 are more of a concern.

She explained levels of squalor:
First degree squalor: You are getting behind in tasks that you would normally manage, like laundry and dishes. You are not the tidy person you once were. Little piles are starting to emerge and your disorganization is starting to affect your life and inconvenience you. Things are just starting to get out of hand and become unmanageable. A sign of first degree squalor could be that you might be embarrassed for other people to see your mess…but you would still let them in the house.

Second degree squalor: Now things are really starting to get out of hand. Signs that you have reached second degree would include losing the use of normal household items like your bed, table, television or telephone, because the piles have expanded to cover the items up. You start to develop new methods of moving around your house, as normal movement is impeded by your piles of stuff. You might start making excuses to discourage people from entering your house.

Third degree squalor: At this stage, you have all the above, plus you have rotting food and animal faeces and/or urine in the house, and this is the rule not the exception. You cannot cope with the growing mess. Essential household repairs may not be done, because you are too afraid to let a tradesperson see your house. Just the thought of someone seeing your mess causes you great stress.

Fourth degree squalor: At fourth degree squalor, you have all of the above, plus you have human faeces and/or urine in your house that is not in the toilet.

Overwhelmed Caregivers, she said are most likely to accept help and downsize, and least likely to repeat the problem. She noted that often a change in circumstance has triggered the problem, or the problem has gradually developed.
Rescue hoarders, she said, often start with the best of intentions, but may believe they are the only ones capable or providing care. “They may tend to avoid authorities, and often have an extensive network of animal welfare people to work with. They may find it difficult to turn away any animal, and feel a strong need to save animals from the possibility of euthanasia.”

She told the session attendees there is no cure, only a reduction of items to focus on safety concerns and aftercare inclusive of everyone who lives in the home and those who give support.

The contradiction, she noted, is that “responding as the client support in a ‘clean out’ means we are having to support enforcement of emotional violation of a client in order to ensure their physical safety, but emotional safety is secondary to the physical threat identified by professionals.”

Some common characteristics of hoarders (not always typical)
-Individuals with hoarding often have personality problems that interfere with their daily lives and that help maintain hoarding behavior
-Excessively high standards and perfectionism
-Excessive focus on details at the cost of the “big picture”
-Indecisiveness
-Difficulty regulating their emotions (e.g., easily upset, difficulty calming down)
-Difficulty trusting others
-Difficulty taking another’s perspective

Sidsworth recommended professionals imagine themselves in the hoarding client’s shoes.
“How would you want others to talk to you to help you manage your anger, frustration, resentment, and embarrassment? Match the person’s language. Listen for the individual’s manner of referring to his/her possessions (e.g., “my things”, “my collections”) and use the same language (i.e., “your things”, “your collections”)…

“Don’t use judgmental language. Like anyone else, individuals with hoarding will not be receptive to negative comments about the state of their home or their character (e.g., “What a mess!” “What kind of person lives like this?”)….  Don’t touch the person’s belongings without explicit permission. Those who hoard often have strong feelings and beliefs about their possessions and often find it upsetting when another person touches their things. Anyone visiting the home of someone with hoarding should only touch the person’s belongings if they have the person’s explicit permission.”

“The risk of emotional and mental damage to a client during an immediate clean out is extreme,” said Sidsworth. “There has to be someone who can support them through the process and identify “hope” beyond the immediate events happening.”

The process was made a bit easier with the presentation of a $23,750 grant presented by Hastings Prince Edward MP Daryl Kramp at the end of the day’s training session. The funds from New Horizons for Seniors will help the Canadian Mental Health Association work with low income seniors to provide them dumping and storage fees and for associated costs to help alleviate immediate threats of hoarding.