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“ Too Much Stuff”

“ Too Much Stuff”. Working With People Who Hoard presented by Malcolm Foster Clinical Leader Social Work Rural & Community Services Waikato District Health Board 31 st March 2013. Objectives. “Enough is enough” too much is….

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“ Too Much Stuff”

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  1. “Too Much Stuff” Working With People Who Hoard presented by Malcolm Foster Clinical Leader Social Work Rural & Community Services Waikato District Health Board 31st March 2013

  2. Objectives • “Enough is enough” too much is…. • History of Hoarding • Defining Hoarding • Contributing factors • Presentations • Working with People who Hoard

  3. Some HistoryBiblical References to “Hoarding”

  4. Ancient Chinese Storage Facility

  5. Ancient American Storage Facility

  6. Modern American Storage Facility

  7. The Growth of Storage • America • Lucrative Business • Social change - divorces, reconstituted families • Economic factors – “keep rather than sell/throw away”

  8. Popularising the subject

  9. When does a Collection become a Hoard? • Evolutionary imperative more stuff => more likely to survive • Alone? – stuff can become your friend • The thrill of acquiring - the addiction of compulsive shopping • A feedback loop – lonely?- pleasure of new stuff

  10. When does a Collection become a Hoard? • Collecting as an antidote to feeling bad –emotional reason • Possible cognitive problems – can’t discern value => keep it all • Hoarders struggle to categorise things • Some hoarders have memory deficits - collect to remember

  11. Cluttering vs Hoarding • Cluttering – accumulating things without too much thought and effort • Hoarding – - obsessing over things – deliberately seeking out things to bring into house – often things with no intrinsic or emotional value

  12. International Literature Frost, R. & Steketee, G. “Stuff” “Compulsive Hoarding & Acquiring” Therapist Guide and Workbook Bratiotis,C. et al “The Hoarding Handbook”

  13. Why Do People Hoard? • Mental health factors • Failure to connect with parents • Genetic predisposition • Upbringing • Emotional clutter • Addiction

  14. Defining the Subject

  15. Addressing Hoarding – What can YOU do? • Assessment first – • Frost’s Hoarding Scale Hoarding Assessment Tool -in home by Randy Frosthttp://www.cornellaging.org/gem/pdf/assessment_tool.pdf • Other scales - Bratiotis Multi-disciplinary Hoarding Risk Assessment http://www.hoarders.org • Pictures (The clutter image rating scale) http://www.oup.com/us/images/treatments/hoardinglivingroomhttp://www.oup.com/us/images/treatments/hoardingkitchenhttp://www.oup.com/us/images/treatments/hoardingbedroom

  16. Working with a Hoarder • Resources - Cornell University Website - Oxford University Website • Frost & Steketee - Workbooks and assessment scales • Bratiotis et al – “The Hoarding Handbook” a guide for Human Service Professionals, Oxford, 2011 • Animal Hoarding – Tufts Animal Care and Condition (TACC) Scale Patronek, 2004

  17. What NOT to do • Bulldoze the client • Start without assessment • Ignore the client’s wishes • Bring out the “Big Stick” first

  18. What is Helpful? • See Cornell University’s Top 20 Decluttering Tips • Relationship - build trust • Motivation - use the clients’ motivation to decide where to begin - “People start to work on their hoarding problem when the reasons for change outweigh the reasons for not changing” • Approach from a “harm reduction” rather than an overall “clean-up” approach. • Be proactive - taking action sooner may decrease complications. • Directly reference regulations and legislation when explaining

  19. What is Helpful? • Know the law • Be aware of medical aspects • Disabled Older people and hoarding • Animal hoarding - Variations - some special considerations - “Overwhelmed Caregivers” - “Rescuers” - “Exploiters”

  20. Tufts Animal Care and Condition Scale(TACC)

  21. Legislation – the last resort • Local Body bylaws - cleansing orders • Mental Health Compulsory Assessment and Treatment Act • Section 126 of the Health Act, 1956 • The protection of Personal and Property Rights Act (1988) – including Enduring Powers of Attorney.

  22. References • “Stuff - Compulsive Hoarding and the Meaning of Things.” Frost,R. & Steketee,., Mariner Press, 2011 • “Buried in Treasures” Tolin,D. Frost,R. Steketee, G. Oxford University Press, 2007 • “Compulsive Hoarding & Acquiring” - Therapist Guide and Workbook. Steketee,G. & Frost,R. Oxford University Press, 2006 “ The Hoarding Handbook”- A guide for Human Service Professionals, Bratiotis,G. et al Oxford University Press, 2011 • “Clutter-Busting Your Life”. Palmer, B. New World Library, 2012. • “The Secret Lives of Hoarders”. Paxton,M. & Hise,P. Perigree, 2011 • Carers.net.nz - article by Dr. Maree Todd. • “Cluttering versus Hoarding” by Jacqui Birchall from: Kiwi Families Website, Jan15th 2013. • “The collectors”, Kate Benson . The Sydney Morning Herald April 8, 2010. • “When does a Collection become a Hoard?” Dr. Fran Vertue, www.christchurchpsychology.co.nz • Compulsive Hoarding and 6 Tips to Help by Therese Borchard, www.worldofpsychology • Cornell University Website; www.cornellaging.org • Oxford University Website; www.oup.com/us

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