Compulsive Hoarding

Many of us may hold onto or ‘hoard’ more things than we should.  We may not want others looking into our closets, attics, basements, or our ‘junk drawer.’   Clutter can arise for many reasons. It may simply be the way some people have always lived their lives. Some people are creative, and like lots of stimulating things around them. But clutter is a fact of life for most.  This information page deals with something more serious, ‘Compulsive Hoarding’ or perhaps ‘Compulsive Hoarding Disorder (CHD),’ where the accumulation of possessions in a living space impedes or impairs daily living, or makes it impossible.  Symptoms can include compulsive collecting and irrational decision-making about what is useful, leading to people keeping garbage or useless items

What Is It?

Drs. Randy Frost and Tamara Hartl of Smith College are credited with the widely accepted definition of compulsive hoarding:

 Behaviour that consists of the accumulation of a large number of possessions that seem useless to others; creating living spaces that are difficult to use; and being prone to impairment such as indecisiveness, disorganization, perfectionism, procrastination and avoidance that isolate them from others.
 

What Things Are Hoarded?

10 Most Common Things Hoarded are:

  1. Paper especially newspapers.
  2. The things used in everyday life which don’t get put away.
  3. Excessive recycling materials which don’t get recycled.
  4. Clothing.
  5. Plastic bags.
  6. Sentimental things which tell a story of happier times.
  7. Mechanical things, car parts, electronic equipment and parts, tools, nuts, bolts, screws, building materials.
  8. Wool, fabric, craft supplies.
  9. Furniture.
  10. Animals.

From: Elaine Birchall of Hoarding.ca

Prevalence                             

Five per cent of the North American population is afflicted with CHD – generally people in their 50’s – that is over 1.75 million Canadians, three times the incidence of Alzheimers Disease.  The City of Vancouver dealt with 96 cases of hoarding last year.  While there is a high prevalence among low-income residents of the Downtown Eastside, hoarding cases were found all over the city, according to Carli Edwards, Vancouver’s Assistant Director of Inspections.

Impact

Like Alzheimers, this disorder affects both the sufferer and their loved ones.  It often gives rise to a safety issue, such as fire from combustibles or flood.  There can also be property damage when systems need repair or are over-loaded, and may include structural damage when large amounts of heavy items exceed load limits in a structure.  There have been extreme cases where a stack of possessions has collapsed on and crushed people to death, or simply trapped them in their home leading them to starve to death.  There are broader public health concerns such as the spread of pests

Hoarding and Tenancies

Hoarding can put a tenant’s rental housing at risk. Tenants are required to keep their units clean and can be evicted if they do not.  Section 32(2) of the Residential Tenancy Act states:

A tenant must maintain reasonable health, cleanliness and sanitary standards throughout the rental unit and other residential property to which the tenant has access.
 

A landlord can apply to the Residential Tenancy Branch to evict a tenant for failure to comply with this provision.  Landlords are strongly advised to first contact the city’s ‘Hoarding Action Response Team’ (see below).  Eviction proceedings should be a last resort.

What Causes Hoarding?

Sometimes people aren’t really hoarders, but their life circumstances change. They are forced to live in smaller and smaller quarters, and are unwilling to give up the things that have been important to them throughout their lives.   Older adults may hoard because the items have special memories for them (such as the old clothes a dead husband wore, or newspaper clippings). They may collect because they consider the items as valuable or the items give them a sense of security. Sometimes, items give them a sense of feeling loved that they can’t find from people.

Other seniors are afraid of forgetting or losing items. They are afraid someone will steal from them or take their personal information so they hold on to everything. In some cases, they have a mental disorder and they feel a constant need to collect and keep things.

There are many other reasons:

  • They are not able to organize.
  • They have trouble taking care of themselves (which is sometimes called “self neglect”).
  • There are many stressful things going on in their lives, and they can’t take care of everything.

Hoarding is a mental health issue, although the exact cause of hoarding is not known.  While CHD may not be considered a mental illness in some, there is often a genetic component.  Another mental problem such as depression or obsessive compulsive disorder (“OCD”) can exacerbate a hoarding situation, according to Elaine Birchall of the Ottawa Community Response to Hoarding Coalition. “Hoarding doesn’t happen in isolation,” she says. “It isn’t just about the stuff. It’s about what else in your life is and isn’t working.”

Some Practical Tips

Hoarders are often not aware that they have a problem, making it difficult to intervene or helping them seek treatment.  Here are some tips for dealing with an older tenant who seems to be “on the pack rat track”.

  • Talk with the hoarder face-to-face about your concerns.
  • Use a soft, gentle approach and let the person tell his/ her story.
  • Ask the senior if he or she can suggest some solutions to the safety issue or health problem.

Intervention

The City of Vancouver has a new ‘Hoarding Action Response Team’ (see below under Resources) that includes inspectors and mental health workers.   As noted below, the team will step away once there are clear pathways, any fire hazards have been removed (e.g. – objects on the stove, combustibles against structures), and any necessary pest control measures are in place.  Those living with a hoarder may not find this sufficient however, and they are very likely to experience repeat behaviour.

Loved ones may want to get professional help for the hoarder to work toward dealing with the root causes of hoarding (see reference to UBC group treatment using cognitive therapy below).   They will also likely want to arrange a more thorough, but sensitive, clean-up (see hoarding clean-up services below under Resources).

As a hoarding intervention specialist, Elaine Birchall tries to help people “change their relationship to the things that they are keeping so that their primary relationship, their primary source of joy and reinforcement, isn’t things.”  The key is “to get people help for the underlying reasons that they hoard, otherwise they’ll just repeat it and have just the worst sense of failure and hopelessness,” according to Birchall.

Hoarding Resources

Vancouver’s Hoarding Action Response Team

As mentioned above, the City of Vancouver, along with Vancouver Coastal Health, have set up a “hoarding action response team.”  This ‘response team’ is composed of a property use inspector, a fire inspector, and two mental health workers supplied by Vancouver Coastal Health.  The response team will have an 18 month trial period.   Residents can call 311 to report unsafe conditions to the city.

The inspectors identify risks to health and safety, and set deadlines and consequences for people who hoard.  The mental health workers provide support to reduce the risks. Inspectors typically ask hoarders to remove combustibles stored against a structure, remove items that block a sprinkler, and to take pest control measures within set timelines that range from 48 hours to three months, depending on the severity of the problem.

Those who don’t comply typically face a $200 fee for fire re-inspection, prosecution for fines up to $2,000, or a bill for cleanup done by a contractor hired by the city. Most cleanups cost $2,000 to $5,000, but have been as high as $15,000, according to Carli Edwards.

“We will leave people alone as long as they are not posing a risk to themselves and others… Many times, we get to a place with the cases where we tell people OK, clear pathways to the exit and clear pathways to the kitchen and get the things off the stove, and then we’re done,” Edwards said. “The goal isn’t a clean and tidy house. The goal is a safe home.”

From: Vancouver Courier Article :
 “City hall mobilizes inspectors in war against hoarders”
September 5, 2012

 The city also intends to develop a “Compulsive Hoarding Landlord and Service Provider Resource Guide.”

UBC Studies

Professor Sheila Woody, of UBC’s Department of Psychology, is leading two studies on hoarding.  These will help the response team identify circumstances that could influence the effectiveness of their work.

“For example, some people have a physical disability that makes it really hard for them to stay on top of the clutter in their house,” Woody said. “So if we keep track of who has a physical disability or a mental disability, that kind of thing, then we know better what kind of resources are needed to support these people, but also it will just help us predict outcomes better.”

Woody and her psychology students have set up a low-cost group treatment for hoarding. Treatment will be offered on a sliding scale and the 20 sessions will be based on principles of cognitive therapy. For more information, phone the UBC Psychology Clinic at 604-822-3005.

 From: Vancouver Courier Article :
 “City hall mobilizes inspectors in war against hoarders”
September 5, 2012

Vancouver Coastal Health

Besides working with the City of Vancouver on the hoarding action response team, VCH provides access to a number of articles and resources on pathological or compulsive hoarding from eMentalHealth.ca, a non-profit initiative of the Ontario Centre of Excellence for Child and Youth Mental Health:

http://www.ementalhealth.ca/Vancouver-Coastal/Hoarding/index.php?m=article&ID=13330

Hoarding Clean Up Services

 Trauma Scene Cleanup is a Vancouver based biohazardous cleanup business, which offers hoarding cleanup services:  http://www.traumascenecleanup.ca/hoarding/default.htm  They also have a blog on hoarding cleanup here: http://hoardingcleanup.ca/

Green Challenge Waste Management offers what they call “compassionate approach” to compulsive hoarding cleanup, guaranteeing that all staff are non-judgmental treating clients with dignity and respect.   http://takethegreenchallenge.ca/services/hoarding/

CanStar Restorations is another company offering hoarding cleanups services http://www.canstarrestorations.com/

1-800-RidOfIt is another junk removal company in Vancouver:  http://www.ridofit.com/our-service/vancouver-junk-removal.php

Other Hoarding Web Links

These web site links are provided courtesy of Lynn Urekar, City of Vancouver Inspections:

Clutter Image Rating Scale best for printing

Clutter Image Rating Scale

Tests for hoarding and description of what the images depict

http://www.ocfoundation.org/hoarding/tests.aspx

Hoarding Assessment Tool

Hoarding Assessment Tool

Hoarding Fact Sheet

Hoarding Fact Sheet

Good tips sheets and tools for housing providers

Tip Sheets and Tools

From a Fire Dept view (after a fire in Toronto)

After a Fire in a Hoarder’s Unit

Scale and tip sheet

Scale and Tip Sheet

Some other websites:

• This is a link that will allow people to download a number of tools and they’re free: http://www.challengingdisorganization.org/node/58

• As mentioned above, Elaine Birchall is a person who deals specifically with hoarding and she also has materials on her site :http://www.hoarding.ca/resources.html

Some Hoarding Do’s and Don’ts

Do

  • Treat the person with respect and dignity.
  • Respect the fact that these possessions aren’t junk to the person. They may feel very strongly attached to the stuff, much as some people feel attached to special people in their lives.
  • Remain calm and factual, but caring and supportive.
  • Reassure the older adult that others will try to help and work with him/her.
  • Work with the medical or mental health services, public health, or other agencies.

Don’t

  • DON’T be critical or judgmental about the older adult’s living situation. Show caring and concern instead.
  • DON’T talk about the older adult to others as if he/she is not present, and don’t make negative, teasing or sarcastic comments.
  • DON’T arrange to clean out the place “behind the person’s back” (e.g., while in hospital—this can leave the person feeling anxious, hostile, in a rage when he or she comes back home).
  • DON’T expect overnight improvement. Go slowly and expect gradual changes.
  • DON’T press the older adult for information that appears to make him/her uncomfortable.
  • DON’T hold a garage sale in your building. The person will probably just add to their collection, not get rid of some of it.

*These suggestions are adapted with permission from the Los Angeles County Department of Mental Health Older Adults System of Care Committee.


DISCLAIMER  – This web page contains legal information, not legal advice.  Every situation is different.  You should see a lawyer for specific legal advice about your situation.

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