During the past two years I have spent much time and energy studying all aspects of emergency responses inside hoarding conditions. There is one key point that consistently comes up, interacting with the occupants. Hoarding or “Compulsive Hoarding” is “the accumulation of and failure to discard a large number of objects that seem to be useless or of limited value, extensive clutter in living spaces that prevents the effective use of the space causing significant distress or impairment caused by hoarding” (Frost and Hartl..1996). The affects of someone having this disorder takes away the ability to make rational decisions, making process to distinguish between an item with no apparent value and one of great value (example: grocery store coupon vs. baby pictures). This compulsive behavior can cause problems with first responders when faced with a hoarding situation. Interaction can prove difficult first due to the unwillingness to leave and second the emotional trauma of strangers touching their “treasures”, understanding and adjusting for these situations is our job to figure out before we run this call. The first adjustment need to be the terminology that we use. Let us look at why we should change our terminology to include “Heavy Content” when describing a hoarded environment.
A very well respected friend of mine that is in a different career once looked me straight in the eye and said “you must be jaded because of all you have seen and dealt with”. After I digested that statement I realized that is exactly what happens. We are jaded by the countless number of tragic events that we deal with on a daily basis and it most often affects how we interact with someone who is encountering an emergency. The very first thing that happens to set the tone of the call is how we present our self; this includes body language and the terminology that we choose. “This is a trash house” or “pack rat conditions” are two terms that first responders use when the discovery of hoarding conditions are found. How would these terms be received if the occupant overheard their house full of treasures called “trash”? If someone called you a “pack rat” how would you feel? They are unable to see their surroundings in your perspective, but it is important for the brief time you spend on the call that you try to see it from theirs.
It is good to remind ourselves of the characteristics of compulsive hoarding disorder. There is deep emotional attachment to belongings, with the inability to distinguish between trash and treasures. This compulsion can cause an overload to the occupant if they overheard these terms broadcasted over the radio or yelled out the window. “Hey chief, this in the interior crews, we have a “trash house”! this statement seems to be a popular description. All it would take would be one radio being around the occupants to have a potential for an emergency for them or you. There have been documented cases of occupants needing to be physically restrained from trying to re-enter a burning home to save their treasures. Another potential danger is the reaction of the occupant in a violent manner towards the first responders. Wouldn’t it make all of our shifts easier if we took away this easy negative and replaced it with such an easy fix.
Being as compassionate as possible during all emergencies is the best practice scenario for all of us, this remains true when dealing with the occupants of a hoarded environment. Occupant safety is the biggest concern of any first responder and when the problem is a compulsive hoarder; words can be just as harmful as flames. Removing terms such as trash house and pack rat conditions will help provide a more neutral environment for the occupant while standardizing the terminology used by first responders.
Heavy Content: A key term
Another key factor in dealing with hoarded conditions is the amount of belongings and the weight exerted on the structural supports of the building. Collecting a large amount of belongings can lead to an overloaded structure, even before the first ounce of water is applied. Using the term “heavy content” should remind all first responders of the overloading potential and collapse risks associated with dealing with a hoarded environment.
A heavy content environment can offer many potential for a collapse, this is usually wither from interior debris falling to a complete collapse of the entire structure. When a building is over loaded with massive amounts of stuff it has the potential to injure or kill first responders. Using the heavy content terminology to identify these potential risks should put all responders at a heighten level of awareness to be looking for collapse. It should also evoke a thought process needed to identify what is being collected inside the building. Identifying items such as books, magazines, or car parts can help with the collapse risk assessment. Another factor that can be used is a hoarding level scale such as the Institute for Challenging Disorganization rating scale of 1-5. If a level 5 is determined, a No-Entry decision may be the best option.
Emergency responders are dealing with compulsive hoarding disorder on a daily basis. There is a huge difference in terminology used worldwide used when describing hoarded conditions, but there is huge effort to change that. From “Colliers Mansion Syndrome” to “Pack Rat” conditions it seems like your terminology is based on a geographic locations. It’s time that we standardized terminology to allow us all to understand the conditions, even if we are not familiar with the term. Heavy Content should be used worldwide to allow a standard, politically correct term to describe these conditions. It offers cues to us all, even if you have never heard of the term before. Being mindful of the compulsion and trying to remain respectful to it will allow us to have an improved public perception and protect ourselves from the potential for confrontation with the occupants.