Hoarding has been defined as the 'persistent difficulty in discarding or parting with possessions ... the behaviour usually has harmful effects - emotional, physical, social, financial and even legal. . .'
The excessive collection and clutter of items puts an increasing number of clients who hoard at risk of homelessness. Excessive clutter can create breaches in tenancy obligations. For most people, hoarding disorder and the collection of items will continue to be an issue for the remainder of their lives. There is no quick fix solution to this problem.
People with hoarding disorder in an elderly population are a challenging group to engage with. Simply scheduling an outreach visit and showing up at the allotted time can be met with resistance and even refusal of entry to the home. The emphasis needs to be on connecting and building rapport with the client and allowing them to be the drivers of change.
VincentCare's Home Care Packages are receiving an increasing number of referrals where it is suspected the client suffers from a hoarding disorder. For the most part, the client has made a decision to accept support services with the view to remain living at home as independently as possible. Referrals often also come from family members or social supports concerned about the wellbeing of the client.
Clients who hoard almost always need help to access aged care services and are far less likely to refer themselves or seek assistance on their own. The safety of the client, the community and care staff need to be considered when accepting a referral of a client with hoarding behaviours.
Effective interventions to help with hoarding disorder can be reflected in small and incremental changes in behaviour. Success may be:
- clearing a small amount of space near the front and rear entrance of their home
to stop collecting items for a specified period of time
- accepting support from an agency
- discarding a handful of items
- the building of trust and rapport between client and support staff.
The important factor is that all of these outcomes are successful interventions for individual clients.
(Adam Dougherty, Case Manager VincentCare Victoria Home Care Packages)