PowerPoint - Hoarding - CCI

Dawn White MHS.,BScN.,RegN
Did You Know
Hoarding is not limited to social class, race,
culture or education level
Interventions are normally costly, complex
and time consuming
Without proper intervention, the hoarders
environment will continue to evolve until the
safety of the individual and the community
might be put at risk
What is Hoarding?
Excessive accumulation and failure to discard
proportionately (animals or things)
Activities of daily living are impaired by
spaces which cannot be used for intended
Distress or impairment in functioning to the
person hoarding or others such as
department/landlord/condo corporations
Is Hoarding Cluttering?
In cluttering the volume is less
Clutterers are still able to discard things,
albeit it may take effort on their part
The clutter does not debilitate their lives to
the same degree as those who hoard
Cluttering MAY be a stage in developing
1-5% of General Population
USA based stats. No stats yet for Canada
Increases as person ages
OCD may be part of it, but is not evident in
majority of those who hoard
In London, those who hoard could range from
3,500 to 17,500 people in the city
If you had a complex of 64 units, with an
average of 2 ppl per unit = 1-6 hoarders
Why Do People Hoard?
No conclusive answer yet but as of 2013 it will
become an official psychiatric diagnosis
It legitimizes it as an illness and not simply slovenly
or lazy behaviour
New brain imaging research (Tolin, 2012) has
revealed that hoarders, when faced with being
asked to pick and discard even junk mail feel
intense discomfort and anxiety
Their brain does not activate the area that allows us
to decide what is important and what is not so
everything can feel important
Why do People Hoard? (cont)
Hoarders also took much longer to decide what to
Parts of the brain responsible for motivation and
insight also under-performed, which might account
for why hoarders are able to live with such extreme
living conditions.
They notice it, but feel no motivation to clean it up
nor do they seem to recognize what a problem it is.
This is also seen in people with autism.
Why Do People Hoard (cont)
Another part of their brain was over-stimulated; the
part which causes attachment to personal objects
and the ability to make decisions about their
possessions that others would consider reasonable
This causes the anxiety, irritability, tearfulness,
feelings of being overwhelmed, grief and sadness
that is the hallmark of what someone who hoards
experiences at the thought of throwing any of their
possessions away
Why Do People Hoard
May be a genetic link
 84% have a close family member with
hoarding behaviour
 37% have a history of OCD
 No conclusive proof, but it does seem to run
in families
 Learned behaviour would also play a major
role as well
Why is this an important
For the person who hoards and their families: It can
create impaired activities of daily living/unhealthy
living conditions/unsafe living conditions
For property managers, condo corporations/general
public who live in close proximity: It can be a legal,
public health and safety issue. Examples may be
vermin, fire load, structural collapse and lack of
ability for Emergency Responders to access the
Often people who hoard will not voluntarily get help.
It is often found by accident
Hoarding Types
Common hoarding
Subcategories of generalist vs specialist
Diogenes Syndrome
Animal hoarding
Common Hoarding
Anything can be hoarded
Generalists save everything. Very valuable
items may be mixed in with garbage
Specialists save only specific items, ie dolls
or tools.
Belief that emotional comfort comes from objects
Objects may be connected to important people in
their lives; therefore the object BECOMES the
Having these objects is almost like having the
person still a presence in their lives
This is why it may be so hard to discard objects. It is
as if they are discarding their loved one
Fear of losing something important “I might
need that!”
Feeling of loss of self or identity
Need for control of possessions
Due to distress of throwing away
possessions; it is avoided at all costs
Characteristics and Beliefs
Just in case—I might need it
Item must be saved because it could be
useful in the future if not for the hoarder, then
for someone else
Sentimental saving– I can’t part with this..it
means too much to me
I love this—aesthetic saving; something
about an object gives aesthetic pleasures
and person cannot part with it
Diogenes Syndrome
Self neglect
Domestic squalor
Found in aproximately .5/1000 of the general
In London this would equal 175 cases
Generally affects seniors
Live alone
Often above average intelligence
Reclusive, irritable, refuses help
Isolates self from society
60% do not have a diagnosable mental illness
(although now with hoarding dx, they will)
Dementia onset may be a factor
High risk and mortality (46%)
Animal Hoarding
Like other forms of hoarding; no one is sure
why it develops
Factors may range from genetic
predisposition to attachment disorders
Research shows that animal hoarders may
grow up in chaotic homes with inconsistent
parenting where animals were the only
source of consistent emotional contact
(Arluke et al 2002, Patronek 2001)
Animal Hoarding
An individual acquiring more animals than they can
care for
Inability to provide even minimal standards of
nutrition, sanitation, shelter and veterinary care, with
this denial often resulting in starvation, illness and
Denial of the inability to provide this minimum care
and the impact of that failure on the animals, the
household and the human occupants of the dwelling
Animal Hoarding
Three types of animal hoarders:
 Overwhelmed Caregiver Hoarder—more based in
reality, become overwhelmed by the number of
animals that they take in
 Rescuer Hoarder—mission driven, they are actively
and compulsively acquiring animals
 Exploiter Hoarder—feel no empathy towards
animals or humans, acquire animals to serve their
own needs
Animal Hoarding
71 incidents across USA and Canada were
83% involved woman ( 71% were widowed,
divorced or single)
53% of AH residences were home to other
individuals including children(5%), elderly
dependents and disabled people (21%)
Animal Hoarders
Often essential utilities and major appliances such
shower, heaters, stoves, toilets and sinks were not
93% Residential home interiors were usually
70% had a fire hazard
16% of AH residences were condemned as unfit for
human habitation
25% of AH were placed under either permanent or
temporary protective custody
What can be done?
Safety is the most important goal. If the fire load
looks extreme; contact the Fire Department. In
London, Inspector James Hind
Public Health Unit for health risks to building, ie
London City Hall has a bylaw that limits animals to a
total of two
London is in the process of forming a community
coalition to address hoarding. City Hall, Fire
Department, Health Unit and community agencies
such as CMHA and specialized cleaning services
Practical Tips for Condo Corp
May need to use all legal means to ensure that unit
is cleaned up. Ie court/bylaws/declarations
If Property Managers are part of engaging clean up
crews; be sure to hire ONLY bonded crews
If the person does not receive help and the risk was
sufficient that a ‘clean sweep’ was done; be
prepared for the situation to occur again
The safety of the neighbouring units may be at risk,
so inaction is not an option if the situation appears
Practical Tips for Condo Corp
Remember the person may be challenging to work
with and may want to resist every intervention, but
safety of others is paramount
If the person ASKS for help, suggest they call
service agencies such as the London branch of the
Canadian Mental Health Association at
519.434.9191, or they could speak to the Fire
Department if they are worried about the excess
materials in their home (not likely, but possible)
10 Most Common Things
Paper especially newspaper
The things used in everyday life which don’t get put away
Excessive recycling materials which don’t get recycled
Plastic bags
Sentimental things
Mechanical things, car parts, tools, nuts etc
Wool, fabric, craft supplies
Animals (Birchall Consulting)
5 Red Flags that Hoarding
Might Becoming a Problem
How many areas of your home can’t be used for
their intended purpose, without shifting things
How easy is it to find things when you want them?
How difficult is it to walk through each of the rooms
of your home because of clutter?
To what extent are furniture tops cluttered?
When you see things you want, do you feel
compelled to have them? (Birchall Consulting)
Hoarding Quiz
Rating Scale: 0=not at all 2=mild 4=mod
6=severe 8=extreme
 Because of the number of possessions you
have, how difficult is it to use the rooms in
your Home?
 How upsetting is it for you to have your
home in its current condition?
 How upsetting/concerning is it for others to
have the home in its current condition?
0=not at all 2=mild 4=mod
6=severe 8=extreme
4. Have other people/agencies tried to
intervene (offer to help you tidy up) because
of the clutter?
5. How difficult/distressing is it for you to get
rid of things?
6. How often have you spent money you don’t
really have because you saw something
and “just had to have it”
If you answered above 2 to questions 1, 4 or 5;
Assess your situation by asking for feedback from
someone you trust who knows you and ask for help
If you answered 2 keep an eye on your situation,
these situations are red flags
If you answered 4 or higher to questions 2,3 or 6
ask for feedback from a trusted friend who knows
you and search yourself for the reasons and your
ability to tackle the problems yourself (Birchall
www.hoarding.ca Birchall Consulting
YouTube: look up Dr.
Dr. Randy
Randy Frost
http://healthland.time.com/2012/08/07/inside-thehoarders-brain-a-unique-problem-with-decisionmaking/ This is the imaging study
38-not-crazy-cat-ladies-hoarding-gets-newdiagnosis?lite This discusses the new DSM
ety_Tips/Hoarding.htm London Fire Dept

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