By Kenneth Willette
The American Psychiatric Association is proposing a clinical definition for the behavior commonly referred to as hoarding. This will open doors to medical, psychiatric and social-services counseling that can be billed to insurance for those struggling with hoarding tendencies.
This started me thinking about my experience with hoarding. While serving as a firefighter in the 1980s, I responded to a cellar fire to which we had to walk sideways through tunnels of stacked newspapers and magazines to reach a smoldering pile of vintage periodicals the resident had collected. I use the term "collected" rather than "hoarded" because he truly managed this with the care of a museum curator. He knew exactly what was in each stack. What to us was a indoor recycling center was to him a valued collection through time captured in print. Two things stick with me from that call: First, the remainder of the home was neat, and second, I never understood his motivation for amassing the volume of combustibles he did.
Then in the 1990s — as a fairly new chief but with nearly 20 years of service to the community — I was aware of some folks whose home or apartment contained excessive amounts of stuff. Often, it was information learned during emergency-medical or public-assist responses. Between notations made on incident reports or change of shift conversation, these people and their locations became part of the intracranial filing system first responders develop, and when dispatched to these locations, I would see a big pile of junk in my mind,(not politically correct I know, but truthful). As a chief, I wanted to reduce the demand for service and tactical risk placed on my troops by these folks .
Initially, I tried to engage with the person who created the condition in direct conversation. What an experience this was, making repeated calls or visits to try to get the hazard reduced. Most of these conversations left me feeling as if I was on a carousel at an amusement park.
One day, the person I was riding this proverbial carousel with was an older woman, and in desperation I reached out to a colleague from our town's senior center for assistance. While we didn’t clear the home of the amassed materials, we were able to tidy up key living areas, reach out to family and get their support to monitor the situation, and reduce the frequency of our responses. Two things stick with me from this experience: They didn’t cover this in any of my training to become chief, and the staff from our senior center was a tremendous resource.
In the 2000s, I had moved on to another department and continued to observe the impact of hoarding on the department and the community. One day, my senior shift commander came into my office and told me he had noticed the roof of Mrs. Adams’s (fictitious name) house had collapsed and thought I should take a drive over and take a look. This was the first I heard of Mrs. Adams’s dilemma and couldn’t figure out why we weren’t responding to the scene and do what we do when a roof collapses into someone’s home. With some quick probing questions, I learned Mrs. Adams was a hoarder, the house looked vacant and word in the neighborhood was she was with relatives. The shift commander suggested we do an on site inspection to assess any hazards.
The home was a two-story, wood frame with an attached garage. Two-thirds of the garage roof and a portion of the house roof had collapsed. It was vacant, with no heat, water or electricity. Judging by physical evidence and aromas, Mrs. Adams had been living here until recently and was using make-shift heating, lighting, and sanitary facilities. She got an A+ for adaptability but an F for housekeeping.
Every room on the first floor had piles to the ceiling and to get to the second floor, we had to crawl over the smaller piles. In one spot, the floor had given way into the basement under the weight of the trash and prolonged exposure to the elements. Making our way through the downstairs, the floor beneath us flexed like a trampoline. This was not a call for social services this was a call for demolition services!
Working with the town building official, we secured the site and initiated the process to have the building made safe or demolished within 30 days. The property owner allowed the town to proceed with demolition. Two things stick with me from this incident: It is amazing the conditions people will allow themselves to live in and the Building Official is part of the team when dealing with extreme hoarding.
Giving hoarding status as a behavioral condition that can be treated by mental-health professionals and others is a good thing. The reality is this treatment usually begins after an incident forces recognition of the problem, so responders will continue to deal with hoarding from well managed collections to excessive accumulations of trash. My three experiences required three different approaches. How many approaches do you have?
Kenneth Willette is the NFPA's division manager for Public Fire Protection.