THE ASSESSMENT PROCESS
Guidelines for services interacting with people living in situations of Squalor and Hoarding:
Squalor and Hoarding are highly complex issues which require a collaborative and integrated approach. Situations of Squalor and Hoarding are often both confronting and shocking to those who come into contact with them. Commonly there is a feeling that the situation needs to be urgently addressed. It is therefore important to remember that situations of Squalor and Hoarding have been that way for long time and they contain many complex circumstances all of which will need to be evaluated and overcome before an intervention can be undertaken.
Careful consideration is required in regards to issues of retrievability, future prevention and sustainability and whether intervention is warranted or possible as well as whether or not the person is capable of remaining living in the community (with or without assistance).
To ensure that a full picture of the situation can be gathered, a number of assessment tools including the Environmental Cleanliness and Clutter Scale have been developed which take into account medical, functional, psychiatric, social, legal and financial implications of Squalor and Hoarding.
These assessment tools help to ensure that as much information about the person and environment as possible can be gathered. They give an easy to use rating system to allow service providers a way in which to objectively document what they are seeing without necessarily gathering a large amount of information from the inhabitant as this can often be quite difficult.
The reality of Squalor and Hoarding and the people who live in these environments and exhibit these behaviours, is that they are often quite difficult to work with, to contact and to gather information from. It often takes many unsuccessful home visits and attempted contacts before the front door will even be opened and even longer before any intervention strategies can be put into place. Working with situations of Squalor and Hoarding requires patience, persistence and determination.
Intervention strategies need to be multi-dimensional and tailored to each individual scenario; they will involve a multi-disciplinary team and long term involvement and on-going support. Things which need to considered are:
The Individual
- Health, finances, supports, willingness and cooperation, ability to withstand the process, future plans
- Public tenant versus privately owned or rented
- Who will support the client during and after any intervention?
- Loss, grief, interference, change of living circumstances
- Need for temporary alternate accommodation
- Legal and financial issues
The Environment
- Risk - of fire, to health.
- Legal issues/Council orders
- OH&S issues
- Is rubbish removal possible?
- Will the situation require forensic or industrial cleaners?
- Pest Control/Vermin
- Are there any pets? Are they being appropriately cared for?
- Will there need to be provision of household goods and replacement of damaged items?
The Property:
- Public housing/privately owned/privately rented/boarding or rooming houses?
- Issues of repairs and maintenance - who pays?
- Are there any council orders in place? Will a clean up require a council order?
- Is the building structurally safe?
- Is there risk of fire?
- Size of premises and enormity of task?
- Future maintenance issues - Is it financially possible?
The Community:
- Is it impacting upon neighbouring properties? Is the damage to adjoining walls etc? Vermin Infestation? Risk of fire?
- Are the community's rights to a safe and healthy environment being upheld?
- Is the situation causing damaged and difficult relationships with the community? Undue stress to others?
When assessing whether or not someone is living in squalor it is important to remember that household cleanliness varies between homes and is influenced by a number of factors including upbringing, peer and family expectations, living arrangements, social and economical circumstances and cultural background. Thus when we speak about Severe Domestic Squalor we are not simply talking about an environment which is untidy or unclean but one which is filthy to the point of being almost uninhabitable.
|
