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Broad idea: changing clients' role in the community from hoarder to a contributing member of society

Engaging clients to impart their repair skills to others

Engaging clients and schools to participate in upcycling hoarded items

Co-create documentary with clients focusing on the significance and meaning behind their hoarded items

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Professionals must take care of themselves and share the caseload with stakeholders and within own organization

Manage expectations- hoarding behavior can’t be changed overnight, monitor risk factors, maintain and build r/s with client

Start with slow approach: pace with client

Break pattern of social isolation

Cardboard group: found a community within themselves but may also maintain the behavior because collecting items can convert to vouchers etc.

Set realistic goals/expectations in case management with other professionals, families.

Psychoeducation of hoarding behaviors in the community/neighbors.

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Family services

Psychology/counseling services

Grief & loss services

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Colleagues: Melissa, Winfred

CMHT: Home visit to clients with MH condition and hoarding behaviours. Has experience in helping clients in the community

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Boys who are excited to help out with community

We have many hands!

Colleagues: Shanthini, Louis

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To prevent relapse of hoarding situation

Identify early warning signs, identify support system

Ct who has meaningful activities their hoarding behavior reduced

Repair kpt: get them included in social activities

Get them involved in skill building to do micro jobs

Mindset: economic motivation, can sell

Do fire safety reasons inspection and use it as a way to remove items

Early 60s demographic

Social space:

People who attend are probably hoarders

3 cate of hoarders:

1. Hoard weird items, 2. personal meaning, 3. want to sell.

Getting client to share the significant meaning of their hoarded items is a breakthrough, rapport not sustained due to professionals change (high turnover).

Sometimes can include convincing ideas such as hoarding behavior affecting elderly people at home. Need consistent caseworker.

Recycling rate: what has value?

Neighbors to befriend (close proximity) and engage these clients to sell/manage behaviors etc.

Educate neighbors on hoarding behaviors (psychoeducation), what can they do to assist?

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In what ways where 2 or more stakeholders can collaborate to manage?

What indicators must be present to determine an improvement of the hoarding behavior?

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To prevent relapse of hoarding situation

Identify early warning signs, identify support system

Ct who has meaningful activities their hoarding behavior reduced

Repair: get them included in social activities

Get them involved in skill building to do micro jobs

Mindset: economic motivation, can sell

Do fire safety reasons inspection and use it as a way to remove items

Early 60s demographic

People who attend are probably hoarders

3 cate of hoarders: 1. Hoard weird items, 2. personal meaning, 3. want to sell.

Suggestions:

Apart from tapping on family, to consider building a community with the neighbours (around the ct)

Educating neighbours about ct/hoarding behaviour --> psychoeducation is important! (Melissa please come :D)

Bringing in Angela's group of networks?

How can they support?

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Grace's Case (2 elderly seniors caregiving for son)

SW's interventions:

Engage mom on the streets and taking opportunity to chat with her to find out more (without disclosing identity as SW)

Q: If hoarding behaviour has been going on for very long time, why was it flagged up only recent?

Ageing parents

Caregiving for son (especially long-term)

Ct's mom: collecting cardboard allows mom to be active and prevent onset of dementia

Q: Before Mom was collecting cardboard, what was she doing?

Selling Yong tau foo ingredients at store - Mom was concurrently collecting cardboard (from 2 decades before) --> Dad suspects that collecting cardboard could be learnt behaviour

Mom has habit to collect all these items - Other items that cannot be sold would be placed at home.

Family used to have a helper that stopped 2 years ago.

Q: (Town Council) Views hoarding as a psychological issue, and it's more appropriate to refer to FSC to meet with family

For rental blocks who leave stuff in corridor, forced removal of items on corridor can be done

TC jurisdiction is public space (staircase/corridor) - fire hazard

Slightly different ball game with clients from purchased flats

Reduction rather than total removal as it can be triggered for the individual

Perhaps the challenge is how to work with the individual/ct while they are still able to go around to collect items (and this time period is uncertain)

Though sometimes the client may agree to the disposal, they might change their mind and end up being at the bin centre (restricted area) searching for their items. This is concerning because they may get hurt

Q: Bringing in family members to speak with Mom?

@~@

Mom's anomaly behaviour is when family goes overseas. When in SG, Mom will still set aside time to gather items before/after gathering.

Q: How do we continue to engage clients who does not wish to engage with usual stakeholders

Q: After initial decluttering, what happens after? Do we close the case?

Client declines service after getting their issue solved (e.g. Fix my light and after that I don't want your services anymore)

Possible future interventions:

Suggest to mom the possibility of scaling up her works for higher returns

Involve CREST for screening of dementia for both elderlies

Involve Ct in other social activities

Engage client consistency instead of closing case when ct starts to decline service

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Suggestions on collaborations

with SASS: co-create documentary through the hoarder's lens, what does collecting cardboard mean? Not be judged but to take a different lens on the meaning of their actions

Video editing

Taking photos of the item itself rather than keeping the item (less physical space taken up)

SSO knows an informal network of cardboard collectors (they meet every Friday afternoon. Meals will be ordered for them, the collectors will come and collect the food and that's when SSO will engage them)

While there might be disputes (who to collect which part), individuals may not stop collecting as they don't want to "give up" their source

However, informal network is quite strong in the sense that the individuals know where each other stay, supporting each other to go overseas

When inviting Town Council for support on clearance of items

Can put a tape/sticker to put on items that client have agreed to throw

TC will not do any sorting; all items will go directly to the bins

Repair Kopitiam

Usually 20 base volunteers to helm the space (average about 12 people needed)

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Focus on child's safety and well being, involved child's school

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Hoarding behavior essentially a long term issue for years, are professionals equipped to manage?

Hoarding items all cleared clients may turn suicidal because finds life meaningless

Hoarding behavior is their safety net/behavior

Look at social support: whats the issues maintaining the behavior?

Social space: facilitate more conversations on hoarding behaviors in informal strategies

Show clients how to package items and labeling before town council can come and discard

Repair kpt: set up with RC/CC as need storage rooms and tools before they can set up (20 vols minimally)

Ktp hospital wellness kumpung: weekly program, vol runs repair clinic, handymen around the community, home visit to repair items

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Engage volunteers in items collected

Repair skills

Colleagues present: Veera, Danny

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Colleagues: Ken

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Colleagues: Daniel

Social Enterprise (cafe, nail salon, workshops)

Opening up a space outside SA (:O)

Welcome to Potong Pasir!

Hires inclusively and involved in rehabilitation of staff

Open to explore: Financially, coming up with solutions

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Helps with coordinating complex cases

Regional Service Team

Colleagues: Yi Fen, Yam

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Knows quite a few seniors who face hoarding challenges

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Context

Client (Ct) has limited/no family support, distant from extended family

Ct has Schizophrenia and lacks capacity to maintain the house, resulting in bed bugs and and hoarding behaviour

Was pushed to clear items that she was not ready for, resulting in suicide ideation

Intervention strategies

Finding out meaning of items kept at home

Sieve through plastic bags to ask each item individually and its meaning

Offer option of donation instead of throwing away, where ct is presented a choice to do (took about 2.5 hours each time)

What worked: Collaboration with different partners

(1) Long-term partnerships

(2) Not imposing our beliefs on cts and impose a change on ct. Finding different ways to work with client.

(3) Co-creation of a new role with client: With the same act (e.g. collecting items)

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Referred by town council

View items as treasure, don't mind donating to others

Severe hoarding issues (inside and outside home, yrs of hoarding)

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Hoarding is a long-term situation, maintain our own expectations that we have of our clients

Hoarding Risk scale: Involving client on whether we can step down?

Please share if we are stressed about the case!

For workers:

Do we know how to identify hoarding behaviour?

Differentiating the different kinds of hoarding behaviour?

Do we know more comprehensively about the networks of the client? Beyond family and neighbours, who else is there?