Psychology/counseling services

Grief & loss services

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

We have many hands!

Colleagues: Shanthini, Louis

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?

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?

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

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?

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)

Repair skills

Colleagues present: Veera, Danny

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

Regional Service Team

Colleagues: Yi Fen, Yam

• 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)

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?