WORKING WITH CLIENTS WHO ARE LIVING WITH HOARDING DISORDER AND/ OR LIVING IN SEVERE DOMESTIC SQUALOR. B Y C A R L Y S T E V E N S.

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1 WORKING WITH CLIENTS WHO ARE LIVING WITH HOARDING DISORDER AND/ OR LIVING IN SEVERE DOMESTIC SQUALOR. B Y C A R L Y S T E V E N S.

2 At CCNB we believe that everyone has the right to get the most out of their life and that some people may need support along the way.

3 WHAT IS THE HOARDING AND SQUALOR PROGRAM? Specialist care coordination support for people living with hoarding disorder and/or living in squalor.

4 WHAT IS HOARDING DISORDER? Steketee et al. (2000) described hoarding disorder as: 1. Compulsive acquisition of objects, with marked and gross associated difficulties with discard, creating avoidance of discard behaviour. 2. Living spaces becoming so full of objects that the use of the room becomes circumscribed or very restricted. 3. Significant associated distress and/or impairment to function.

5 PREVALENCE Estimate of 2-5% of the population experience hoarding disorder. Prevalence increases if age is over 55 years.

6 HOW HOARDING DISORDER CAN AFFECT PEOPLE S LIVES Physical health Self- neglect Families Housing Accidents and Fire Financial costs

7 WHAT IS SQUALOR? When a person s home is so unclean, messy, and unhygienic, that people of similar culture and background would consider extensive clearing and cleaning to be essential. Accumulated dirt, grime and waste materials extend throughout the living areas. From: Severe Domestic Squalor John Snowdon, Graeme Halliday and Sube Banerjee (2012)

8 WHAT HAPPENS WHEN I REFER? A care coordinator will be in touch with the referrer to get background information before getting in touch with the individual An specialist assessment will be conducted including goal setting for the individual A holistic care plan will be developed, including a safety plan Referrals will be made to various support services

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10 CASE STUDY MRS E (LIVING WITH HOARDING DISORDER)) Case Management for Mrs E has included: - Linkages to Hoarding specific therapeutic support (both individual and group based) Working collaboratively with MH stakeholders Engagement with specialist care workers to support Mrs E to reduce the amount of possessions in her home Home Care Package Addressing safety issues Exploring options around falls prevention Linkage to the obesity clinic Mrs E now has strategies in place where by she is clearing a certain amount of possessions herself each week without her worker and she has significantly reduced tendencies to acquire possessions

11 CASE STUDY MS O (LIVING IN SEVERE DOMESTIC SQUALOR) Case management for Ms. O has included: - Collaborative working with Prevention of homelessness program. Attempts to link to various medical/ mental health services. Risk minimisation Liaison and advocacy with Department of Housing. Linkage to Mental Health Services. The future monitor wellbeing, linkage to NDIS and support services.

12 Different approaches are required for different individuals. One size fits all approach will NEVER work!

13 HELPFUL TIPS. Language match the clients language, be respectful, use encouraging language. Seek to understand the clients perspective ask instead of telling Use I statements to express concern Focus initially on safety and organisation Regularly check in with client goals Highlight clients strengths and praise progress Acknowledge feelings you may witness

14 WARNING QUICK FIX CLEAN UPS WARNING!!! Imposing controls and cleaning up without respecting the needs of the person living with hoarding disorder leads to rapid relapse and highly reinforced resumption of hoarding behaviour (50% more) There is no quick fix for people living with hoarding disorder. This is an chronic ongoing condition. It is better to understand the personal context, build rapport and motivation and work on small improvements

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16 MORE INFORMATION Carly Stevens CCNB Ltd Unit 10/11, Level 1, Pittwater Place 10 Park Street, Mona Vale 2103 Ph: (02) Fax: (02)