Is there a ‘home’ in Hoarding and Squalor environments?

Statistics gathered from Catholic Community Services, NSW state that more than 1 million Australians may be experiencing hoarding and squalor type behaviours in their homes (www.catholiccommunityservices.com.au). This topic, although not new, is high on the agenda for many community organisations within Australia and Footprints joined the growing queue. Between 2009 and 2012 a clear increase was observed of people entering Footprints programs due to issues of hoarding or squalor. These referrals were not limited to housing support programs but also mental health recovery and community care programs.

Within the Community Care Team a Case Management model of support from a strengths framework is used when working with all clients. This has proven vital with the increase in need for intensive support required when working with a person experiencing hoarding or squalor. Although not a speciality service identified or recognised with any type of funding; supporting clients experiencing hoarding and squalor has been a service provided like any other such as shopping, cleaning or personal care support.

Through engaging in intensive case management, the Footprints Community Care Team has observed the emotional and psychological affects hoarding and squalor has on our clients. We have observed their changed views of what ‘home’ means to them when ‘home’ is more of a storage facility than a sanctuary. Within the case management model, new psychological techniques have been explored related to ‘ontological security’ and the concept of a ‘therapeutic landscape’.

Research has shown the importance of place and it’s relationship with a persons health, physical and/or mental well-being and the opportunity for a persons ‘place’ to be both healing and/or hurtful.  Our clients evidently commence having conflicting views of their ‘place/home’ given their battle between the anxiety surrounding their ‘stuff’, the joy it brings them and the difficulties associated with acquiring more and more items (eg tenancy issues). A gradual and patient approach to working with clients addressing these complex issues has proven the most successful. With small milestones recorded along the journey.

For example, 70 year old Mrs. B’s small unit was overrun with large amounts of belongings piled as high as the ceiling posing not only an issue for her tenancy but a fire risk also. The first milestone reached could be viewed as a small one however is the biggest step for people experiencing these behaviours, and that was to throw something away. Staff working with Mrs. B expressed great joy at being able to support her to throw at least one bag of items away each visit, eventually over time producing a beautiful lounge room for her to use.  

The value of time also needs to be significantly noted when working alongside someone experiencing hoarding behaviours. Time is required to address the nature of the hoarding environment practically but is also essential to validate the psychological well-being of individuals given the anxiety they experience. Time offers our clients a sense of routine, order and continuity which promotes a stable mental state/ontological security.

Working alongside professional organisers, psychologists and counsellors, Footprints Community Care Team Case Managers have been able to provide a growing sense of ‘home’ and security to our clients experiencing hoarding and squalor and will continue to do so in the future. Watch this space for more…..

Aynsley Le Man

Coordinator, Community Care Team

Resources:

Giddens, Anthony (1991) Modernity and Self-Identity. Self and Society in the Late Modern Age. Cambridge: Polity. (sourced through Oxford Journals online www.oxfordjournals.org)

Williams, Allison (2007) Therapeutic Landscapes. Aldershot: Ashgate Publishing. (sourced through Health Sociology Review http/hsr.e-contentmanagement.com)

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