Hoarding is not a problem fixed quickly, or in isolation. Media often focus on extreme decluttering as being the solution to a hoarding problem. Most people are not aware that there are alternative options that may better suit their needs. We learned in Module 2 that clutter is only a symptom of the problem. Clearing the clutter does not fix the problem. Our objective in decluttering is to minimise immediate risks and create a foundation for long term improvement.
The strategy employed will depend on:
- The urgency of the problem
- The persons willingness and capacity to engage
Do not expect the client, or other stakeholders to understand the decluttering options available to them. Being able to suggest alternative options helps you to establish yourself as a professional service provider.
Note: Some of the strategies for decluttering in this module also mention cleaning. The environment may be squalid, and require cleaning and/or rubbish removal. It is important that these jobs are carried out by specialists with appropriate skills and personal protection equipment (PPE). In Module 7, you learned how to brief these service providers to ensure they are not only experts at what they do, but sensitive to your client’s needs as well.
Harm Reduction
The most challenging hoarding situation to deal with is a treatment-refusing client living in a dangerously cluttered environment. In this situation, working in a Harm Reduction model may be your only option.
Harm Reduction prioritises the safety of the occupants. It is based on the clean needle philosophy. You may not be able to stop people hoarding but you can make them safe. Attention to fire safety, unblocking exits, and the elimination of trip hazards take precedence over changing behaviours.
The Department of Health in Victoria, Australia, acknowledges Harm Reduction as a legitimate option in severe cases. “The Department of Health is aware of issues affecting a broad range of service providers when responding to situations involving hoarding behaviour and squalid living environments. The department acknowledges that these cases are complex and progress can be slow, with many not reaching a resolution. An objective may be to ensure the safety for the person concerned and their dependants and to minimise risk.” – Aged Care in Victoria, Hoarding and squalor, Dept of Health, Victoria
In practical terms, the client can be engaged in a conversation about safety. This can feel less judgemental than a conversation about having too much stuff or emotive observations about how they are living. The Hoarding and Fire Risk Checklist is useful in starting a conversation, and agreeing goals to improve safety.
The Uniform Inspection Checklist is popular in the USA and provides a more extensive safety assessment tool.
Install smoke alarms and test them.
Unblock exits and clear pathways in house.
Check all water, gas, electrical wires and plugs are connected and operate safely.
Remove clutter from cooking areas; for example, stovetops.
Remove clutter from electrical items; for example, heaters.
Out in the Real World
Violet knows how to get a job done. If you haven’t used something in a year- out! Multiples of something – chose the best, toss the rest! Her friend June just needs to get a skip and get rid of her clutter. She’s got the number of the skip bin company ready and can’t wait to help June fill it but for some reason June won’t let her make the call.
Agencies in Melbourne can use the Hoarding Notification Pack to register affected properties onto the Hoarding Notification System. This places a discreet alert for responding fire crews that they are turning out to a property with a high fuel load and allows them to prepare. It advises crews that the occupant also has an increased chance of being trapped and needing rescue.
You may not be able to stop people hoarding but you can make them safe.