This is part 2 of our feature on hoarding. Click here to read part 1.
So, we haven’t found the solution to ‘cure’ hoarding behaviour - in fact, we’ve only begun to scratch the surface! However, over the years, we’ve learnt precious lessons on how to better work with the nuanced, complex hoarding cases we come across.
In our earlier years, our focus was to declutter the home in the most efficient way possible. Our logic was simple: the faster we could get rid of the junk would mean that the auntie or uncle in question would get a cleaner, safer place to call home. We quickly realised that not only was this ineffective, but also some homeowners were so traumatised by the whole experience that they would shut us out completely!
On further thinking, this makes sense. Just imagine: you have been scolded or nagged by all your friends and family about the condition of your house. They insist that what you are collecting is rubbish and one day a bunch of strangers show up at your door and start throwing out almost everything in sight. Items start piling outside and your neighbours peer in and make all sorts of nasty remarks. This is why you had your door shut in the first place and now it seems like the whole world is against you - no wonder such homeowners get overwhelmed.
Ultimately, we learnt that we needed to keep our focus on the heart of the matter: the person, not the things.
What worked well?
Well, over the years, we’ve learnt the following:
1. To carefully manage the emotional state of everyone involved in the session.
We have seen sessions where the homeowner got so agitated that he lunged at a volunteer to stop her from touching his items. Thankfully, there was no serious injury. Dealing with hoarding cases requires a lot of patience and understanding on our part. For the first few sessions, we would usually require social workers to be onsite to help manage the mental and emotional state of the homeowner, as they would have already built some form of rapport with the homeowner before we are roped in.
2. To go at the homeowner’s pace
The work we do is only effective when the homeowner is ready to change. Else, even if we force our way, the ‘change’ will not be long term and we ultimately get nowhere. Depending on the homeowner’s state of mind, a session can run for as short as 10 minutes. As much as we can, we try to involve the homeowner in the decluttering process and decision making. We want to make sure that the homeowner feels secure and in control, and that they have ownership over the home rehabilitation.
3. The importance of having a mental health professional involved
Although some and not all hoarding can be a symptom of other psychiatric conditions, we’ve learnt that professional medical support can go the long way in catering to the homeowner’s emotional and mental well-being.
4. The importance to maintain a stable presence
In the thick of an overwhelming decluttering process, it can be reassuring for the homeowner to see familiar faces across the different sessions (especially since hoarding cases may take multiple sessions which span over a long time). There is a need to build trust and rapport with the homeowner – knowing what he/she is comfortable with and getting better at identifying which things they would like to keep or are agreeable to throw.
This is why we only allow full-time staff and volunteers who can commit to frequent sessions to join rather than opening up such sessions to ad-hoc volunteers until we have assessed that the homeowners are ready.
5. How to balance respect, compassion and gentleness with wisdom
Very often, there is a strong element of shame present in the homeowner and we need to make them feel safe in our presence. But at the same time, we need to know when and how to be firm with them, jolting their thoughts on the state of things – for example, “We have spent 4 hours and only this 1 trash bag was filled. How far do you think we have come in creating a space in this room to place a bed for you to sleep on?”
The sensitivities involved is also why we face difficulty doing media coverage on such cases, making it doubly hard to educate the public on the gravity of hoarding.
There’s always room for more compassion
While we have learnt plenty in our hoarding journey, we still do not have all the answers. But we are deeply committed to researching and piloting long-term solutions for homeowners suffering from hoarding tendencies and hope to better understand the psyche in order to work in a collaborative, dignified manner – no matter how long it may take, or how challenging it may be.
Why? Because hidden behind the mountain of items, the social nuisance (sometimes even danger) caused, stench and pests under the rubbish, there is a person who has a story to tell, just like you and I, who deserve our support. They don’t deserve to be living in a home which threatens their health and creates immense emotional and psychological stress.
Next Steps
So, how can you help?
Hoarding cases are mostly fronted by staff and our regular HomeWorks Champions due to the sensitivities and extreme nature of these cases. We are always looking for more committed volunteers to support the work.
Our work is also powered by funding to keep it going. Most of the donations we receive only cover the direct costs of materials, but not the man-hours pitched in by staff. Hoarding cases take up a lot of time – not just during the multiple sessions required, but also the time working with community partners such as social workers and the town council to ensure that the work is effective in the long haul. We need more regular donors who are willing to support this front.
Habitat Singapore works on such case referrals from official community partners in order to holistically serve homeowners. While Habitat Singapore is committed to using our expertise in home rehabilitation to support homeowners on their journey towards a fresh start, the social workers and professional medical workers we work with make sure that the change does not end (or worse, is reverted) the moment the home is clean. Many helping hands come together to ensure that a homeowner receives effective, long-lasting support.
If you know of someone who you think may be engaging in excessive hoarding and would like to refer them for home rehabilitation services, please contact the Agency for Integrated Care or your nearest Family Service Centre for assistance.