Cambridgeshire Fire and Rescue Service Community Fire Safety

Cambridgeshire Fire and Rescue Service Community Fire Safety Group

Hoarding

Definition of People who Display Hoarding Behaviour • • • Organised Rubbish Animal Contamination Food Own Waste

Organised hoarder

Rubbish hoarder

Food hoarder

Animal hoarder

Contamination hoarder

Own waste hoarder

Myths (1) • Hoarding is extreme disorganisation • Not true. People who display hoarding behaviour can be organised, the process is not about keeping items but the emotional attachment to them

Myths (2) • People who display hoarding behaviour don't mind clutter or dirt • Not true. They tend to mentally block out the mess because they can’t handle it. Their emotional attachment to the collection supersedes their own feelings on cleanliness

Myths (3) • A good spring clean is • Not true. This would the best way to be traumatising. resolve the problem Therapist would strongly advise against this, hoarding is a coping mechanism and healthier options must replace their desire before they can let go.

Myths (4) • A person who displays hoarding behaviour will never stop • Not true. A person may be able to lessen their tendancy to gather things, or may eventually be able to stop, if they find they can use a form of support. . They may be suffering from a disorder, and if addressed could help them to stop collecting and begin to free themselves

Myths (5) • People who display • Not true. A common hoarding behaviour misconception, the are severely mentally person is usually ill trying to recover from a traumatic experience, or it may even be a life style choice – knowing the person is the best place to start

Reasons (1) • It may be a learnt/socialised lifestyle choice • A person who compulsive hoards will see potential in almost every object they come across. • They need to have control over their lives

Reasons (2) • They have an enormous oversentimental attachment to objects • They are likely to have a perfectionist personality • They dispose of 'anything' very slowly.

How does hoarding begin? (1) • Hoarding has, until recently, been defined in mental health terms under the umbrella term 'Obsessive Compulsive Disorder' - OCD. • In May 2013 it became a recognised mental disorder and was included in the manual ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM), provided by the American Psychiatrics Assosiation • For many people who hoard, there is a highly individual trigger. Often this will be a well hidden cause that the person does not like to share and may retreat within themselves. • The trigger can be anything from poverty, unemployment, bereavement or abuse and it will have made a significant impact on the primary socialisation of the individual.

How does hoarding begin? (2) • It is unlikely a person will disclose their trigger because of the pain associated with it, or perhaps they actually dont recognise there is a problem • They face anxiety as a result of their trigger and begin to 'hoard' objects as a way to ease the pain/anxiety they feel. • Classically they also surround themselves with objects for security or comfort, surrounding themselves within a secure 'cave' of objects or a labyrinth which is difficult to penetrate.

When does it Peak? Have a guess • 25 to 32 years old • 35 to 42 years old • 45 to 52 years old • 55 to 62 years old • Most cases tend to present themselves between the ages of 55 to 62 years old. • However not everyone will present symptoms this late in life as there have been reported cases in people as young as 13

Risks (1) Hygiene • Showering and washing become forgotten habits for some people. • They may also start using their baths/showers as storage for their hoard.

Risks (2) Money • They will not concern themselves with spending money on themselves if they see something that they desire for their hoard. • They will happily spend money on new items that will be of no benefit to them. • They will even spend money on items they already but can no longer find.

Risks (3) Heating • Heating becomes an unnecessary expense. • They may block off their boiler with their hoard and resort to electric blankets or small heaters to provide their source of warmth. • This is an extreme fire hazard. • If a fire does start then it would begin to consume the hoard very quickly.

Risks (4) Food • Whilst some people will collect copious amounts of food, they will not concern themselves with using it to feed themselves. • Instead they keep it as part of their hoard and become attached to it. • They will still eat but they will not prepare nutritious healthy foods. • Resulting in using out of date food which would be a health hazard for them.

Risks (5) Family • People will usually be separated from their families and this can be cause of their condition. • They will not attempt to reconcile as they are too busy gathering their hoard. • For anyone that still has a family surrounding them, when they start hoarding, their relationships will begin to suffer.

Outside risks (1) Bullying • A person can become more vulnerable as their condition worsens, subsequently they may be taken advantage of by some individuals around them.

Outside risks (2) Isolation • As the person take more and more comfort in their collection they become more isolated from the community. • Collecting takes over and the possibility of real human interaction soon gets lost. • It becomes a vicious cycle.

Outside risks to the peerson who hoards Ridicule • Hoarders face being ridiculed for their behaviour. • This can cause the problem to get worse.

Risks to neighbours • • • Infestation Fire Smell Social Stigma Effect

Risks to staff • Challenging can lead to aggression and potential violence. • Entrance and exit to the property may be difficult. • This may cause some real problems if a quick exit is needed. • You cannot rely on natural lighting. Getting around the property and avoiding slips and trips may be difficult. • You may not be able to see what you are walking on, therefore good footwear and caution is required. • The person may tral cables from room to room, s they are unable to locate power sockets.

Treatment Cognitive Behavioural Therapy (CBT): • Is the main form of treatment for compulsive disorders such as hoarding. • Is a technique that can be used to help people better understand the thoughts and feelings that lead to potentially problematic behaviours. • Has a range of uses, but it can be particularly effective when treating phobias, anxiety, additions, and depression. • Is usually considered a short-term option that focuses on a very specific set of behaviours. • Is very useful in dealing with the 'here and now' in solving problems and proposing solutions.

Treatment Pharmaceutical treatments • Prescribed medicationis another form of treatment that may help. • Research is currently ongoing in this area however the most common type of medication is usually Selective Serotonin Reuptake Inhibitors (SSRIs). • SSRIs are primarily an antidepressant however they can help alleviate the anxiety, which in turn may help release them from their need to collect. • The higher a patient scores on a scale of hoarding symptoms, the less likely they are to respond to SSRI treatment. • Compulsive hoarders often suffer with depression, so treating the depression with SSRIs is often helpful as long as it is combined with another form of support

Taking Action as a Fire and Rescue Service (1) • The Fire Service has no legislative powers in domestic properties • We will refer to partner agencies when the safeguarding of the resident is compromised in particular fire or infestation.

Taking Action as a Fire and Rescue Service(2) • A Community Fire Safety Officer will visit and attempt to fit Wi-safe smoke alarms and a carbon monoxide alarm. • Carry out a full home fire safety check. • Offer advice on a home fire escape plan • Discuss the dangers seen. • Ascertain if the service we can visit again bringing a colleague (another agency) • Complete a referral form and submit to Service Safeguarding Officer before being forwarded to MASH. • Record all information on Service data base. • Inform Combined Fire Control of the scale.

CIR (Clutter Image Rating) • We use this scale rather than taking photos. • Taking photos can distress the person – they may see it as an invasion of their privacy • By using this scale we can all understand the level of the hoard.

Taking Legal Action (1) • An anti-social behaviour order In partnership with other agencies a civil order made against a persistently anti-social individual which restricts his or her activities or movements, a breach of which results in criminal charges.

Taking Legal Action(2) • A demoted tenancy In partnership with other agencies a reduced level of tenancy can be applied for. It removes a number of tenancy rights, lowers security of tenure and makes it easier for a landlord to seek possession or evict a tenant if they do not improve their behaviour.

Taking Legal Action (3) • An injunction Injunctions can either be 'final' (part of the decision of the court after all the issues have been heard at trial) or 'interim' (made at an early point in the case before all matters have been heard). Most injunctions are interim, providing an immediate remedy.

Taking Action • Power of Entry Capping the Gas ? • Possession / eviction This is the most extreme method of dealing with a hoarder.

Taking Action a Balanced Approach(1) • The best way to move forward if you have a resident that is a hoarder is to try and take a balanced approach. • Try to take the hoarders needs into account as well as the associations, (yours and others agencies). You are not just dealing with a difficult tenant, you are dealing with a person that has a mental illness. • It is important to remember that any action you need to take will result in the hoarders anxiety levels increasing. This in turn can lead them on to a path of increased / excessive hoarding which may only make matters worse.

Taking Action a Balanced Approach(2) When taking action consider: • • • The risks - are they containable? Your policy and procedure The impact on your organisation if you lose The impact on surrounding neighbours if you lose The increased risks that escalation of hoarding may pose A balanced approach of containment is usually the better option.

Mrs X

Mrs X (2)

Mrs X

Taking Action # Disadvantages of taking action for other agencies • Cost • Impatient and unhappy neighbours • A route you cannot pursue again

Engagement(1) • Preparation is essential • Check with other agencies to see if they have had previous contact with them. • Arrive early

Engagement(2) The Visit Front door

Engagement(3) The Visit • Behaviour • Maintain eye contact. • Try not to look around

Engagement(4) The Visit • Conversation • Try not to focus on the hoard.

Engagement(5) The Visit • Body language • Watch their body language carefully, they will try to lead you away from areas that are most important to them. • They may purposefully lead you through the house in a deliberate way so as to avoid their prized possession.

• Support Engagement(6) The Visit • Use sound judgement about the type of support they need. • Are they aware that they have a problem or are they in complete denial? • Do they seem willing to confront the problem?

Engagement(7) Moving forward Offering Support • Are they ready to accept support? • Are they in complete denial or are they aware that they need help? • It will be difficult to work with a person if they are in denial about their problem.

Engagement (8) Moving forward How do they live? • Are they compromising on the basic living essentials that most people take for granted? • If so, then help, support or acknowledgement of the problem may not be an option as they are already demonstrating what they are willing to sacrifice. • You will need to seek professional advice on how best to help them

Engagement (9) Moving forward What are you dealing with? • You need to consider this when choosing to move forward as it will help you to measure the risks involved.

Engagement(10) Moving forward Are they willing to change? • If the person is receptive of the need to clear out some contents then be patient and think small. • Remember the emotional attachment they have to their hoard. It may take them weeks to clear a room that we might clear in a day.

Engagement (11) Moving forward Do not place them under undue pressure • Remember that increased anxiety levels will trigger the need to collect and could escalate the situation further.

Thank you Any questions Photos post fire Information sourced from social housing via National E Learning web page