Hoarding & Emergency Response

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When responding to emergencies, the Tempe Fire Department and the city’s Care 7 crisis response team is seeing an alarming number of homes that are so littered with trash and debris, or are so packed full of stuff, that they’ve become a hazard to the occupants and to firefighters trying to put out a fire. Representatives from Tempe Fire and Care 7 talk about the problem.

Ted Simons: The Tempe fire department is responding to an increasing and alarming number of house fires involving hoarders. Homes that are packed full of stuff can present a variety of hazards to emergency responders. Joining me to talk about the problem is Tempe fire captain Mike Kuehl who was injured in a fire attributed to hoarding. Also joining us is Tempe fire inspector and investigator Michael Reichling. And Kristen Scharlau, who is the program manager for Tempe's CARE 7 crisis response team. Good to see you all here.

All: Thank you.

Ted Simons: Let's get a definition and I know some don't want to use the word "hoarding" but what are we talking about here?

Michael Reichling: We're talking about individuals that have collected a lot of combustible materials. It gets overwhelming for them and causes a real hazard for them personally. Especially for firefighters when they go in on a emergency medical call, for instance, and especially with a situation where there's a fire -- you know, a very dangerous situation with fire.

Ted Simons: Are you seeing more of this out there?

Michael Reichling: We've had four fires within the last six months, just in the city of Tempe.

Ted Simons: Why do you think that's happening?

Michael Reichling: Because of the economy and we're getting more of aged community within the city of Tempe. But more than that is across the county in the state, nationally, we are seeing an increase.

Ted Simons: And it can be dangerous as you found out. Tell us what happened in your situation.

Mike Kuehl: Approximately two months ago, responding to a single truck, unknown fire. Initial reports came in that there was some material in the backyard that could have been on fire. While in route, they balanced it to a three in one structure fire. The fire made it into the house. So upon arrival we found exactly what's happening? There was a large quantity of materials in the backyard had made its way to the attic of the house and took command of the fire and proceeded to come forward and go in the house and do a search and rescue on the house and when I came out, my firefighter was there -- hey, I opened up the front door, it's clear. I think there's just the fire in the attic. I took off my helmet and hood to put on my mask and while kneeling down, something in the attic exploded and a large quantity of heat and fire and smoke and lot of material came shooting out of house and the front door.

Ted Simons: And that's a difficult aspect of this, you really -- I mean, until you get in there, you don't know what's going on in there, do you?

Mike Kuehl: That's correct. I had a head start on this, as I looked in the front door, I could see the hallway stacked with boxes up to the ceiling. And two to three feet you could actually get through the hallway.

Ted Simons: When you go on the calls and obviously something is wrong here, do they know something is wrong here?

Kristen Scharlau: I think some do recognize that there's a problem. I think in order to survive; they minimize the situation and maybe call themselves collectors or just that they like to hold on to stuff. But a lot of them have been in isolation because they know something is wrong.

Ted Simons: What are they collecting, holding on to? I understand -- I think we all know about situations -- animals are often involved, aren't they?

Kristen Scharlau: They are. I think people collect something that's important to them. For some people it could animals, for others it's paper, pictures. Things that are important and mean something to them. Maybe from when their children were small. They keep everything. Whatever comes in the house, stays in the house and never leaves the house.

Ted Simons: We're seeing examples here and some say that just looks like a messy house as opposed to a real problem. What's the difference between hoarding and just a mess?

Kristen Scharlau: A messy house can be picked up in a short period of time. A hoarder takes a while and probably professionals that come in and help separate the trash from the items that should be kept. And we are talking about people who have pathways in their homes. They have just enough room so that they can get to the restroom or the kitchen and they can't go anyplace else.

Ted Simons: And that becomes a problem if there's an injury, an illness in the house. You've got to get in there and I'm guessing a lot of times you can't.

Michael Reichling: No, you have to force yourself into the structure itself and impeded to the -- by the boxes and trying to get to the patient. The patient is in an isolated area. If Mike has to start compressions for a heart attack, they have to take the person outside because there's no room in the house to actually do CPR.

Ted Simons: Do you get a chance to talk to these folks. What are they saying?

Michael Reichling: As a investigator, we're hearing that it's just a normal course of their lives. These are just materials dear to them and in their own home. IN this case with Mike, with the explosion occurring, it brings more of a concern for us and the individuals -- that's why we're doing these programs. We want to get to the occupants and friends and family to make sure we get some of the solutions, get people to realize they need to help these individuals.

Ted Simons: Has it changed the way you approach things when you're on call? I'm guessing this isn't the first time you've seen a house like this, I hope, that's attacked you like this. I mean, what are you doing now? Changing your approach?

Mike Kuehl: This is the first time I've been injured in a situation like this. There's help these people can get and using that resource and getting them the help they need, for the most part, it's a mental health issue and it's important that this is a disease and get the people the help they need. And also, it's a safety issue for them. There are so much quantities of combustible materials if there's a fire it can grow so fast and there's only one way out of the house, it's dangerous for the people living there. And also their neighbors because these houses start burning and it can take off.

Ted Simons: When you show up on these sites, what does CARE 7 do?

Kristen Scharlau: It's the city of Tempe crisis response team. We're dispatched with 9-1-1 calls with firefighters and police officers and help people connect to resources in the community and deescalate situations and get people connected. What we would do is help the people what may be going on and try and assess what they already know about the situation and what they feel comfortable talking about, and what they feel comfortable doing something about. Do they feel comfortable doing something about it and we'll help hook them up with resources and follow them long term.

Ted Simons: And family is important. Friends and family.

Kristen Scharlau: I think that those are people who can be successful. The hoarders do have friends and family who care about them and help them, those are the people that are going to be successful.

Ted Simons: Thank you for joining us tonight on "Horizon."

All: Thank you.

>>> Sign up for "Horizon's" weekly e-news. You'll be among the first to know the coming week's programs and guests. Sign up at azpbs.org/horizon.

Ted Simons: The Arizona hoarding taskforce was created about a year ago to respond to what we've just heard described as a growing problem. Joining me now is Linda Buscemi, a licensed therapist who chairs the Arizona hoarding taskforce. Good to see you. Thanks for joining us.

Linda Buscemi: Thank you very much.

Ted Simons: What's your definition of hoarding?

Linda Buscemi: It's the excessive gathering of items to the point where they can -- the person can no longer function in their homes. They're using their stove as a storage. That's how bad it can get.

Ted Simons: How is it diagnosed and is it diagnosed as a condition or a symptom?

Linda Buscemi: Right now, it's diagnosed as a symptom of other diagnoses such as OCD, which is Obsessive Compulsive Disorder, Anxiety, depression etc., you can go on and on. In 2013, the DSM which is Diagnosis Statistical Manual is under review to hope to make it an actual diagnosis.

Ted Simons: And again, these are basic questions here, but seems most of the stories involve older folks. Is that what you see as well?

Linda Buscemi: According to research, it typically starts in adolescence and chronically gets worse but, yes, mostly in elderly folks.

Ted Simons: That would come to mind the question of prevention. We all like to collect some stuff. If you know the stuff -- who really collects too much, how do you know? How do you prevent something like this?

Linda Buscemi: That's a good question. Sometimes it's based on family too. If you're a mom or dad and hoarding items your children will see that. There's a family dynamic too and stressful life events that occur that can create the issue too. How to prevent it, we're not quite sure how to prevent it.

Ted Simons: When you talk about mostly older but starting young, what you're seeing is mostly older. Talking about couples or folks living alone?

Linda Buscemi: In general, usually females that are unmarried that are actually -- are the hoarders.

Ted Simons: And again, do they look at the books they're keeping, the cats all over the place, the boxes -- looking at these things almost as family members, is that the attachment there?

Linda Buscemi: I want to specify that animal hoarding is different from hoarding different items.

Ted Simons: How so?

Linda Buscemi: We think there's a different component emotionally. If you go into an animal hoarder's home, there are typically not boxes of papers stacked up and vice versa.

Ted Simons: I see.

Linda Buscemi: We're learning on that - as far as animal hording goes but it seems to be distinctly different.

Ted Simons: But the idea, either/or, the cats are family members and books and boxes -

Linda Buscemi: Possessions.

Ted Simons: And you take those things away, bad things?

Linda Buscemi: Bad things. A golden rule is you don't want to just take something away from a hoarder's home. It raises anxiety. It's like me going into your home and taking your prized possession. Even though we think it's worthless, it's not to them.

Ted Simons: Do they know something is wrong here?

Linda Buscemi: I don't think they do from the start. I think they think it's their possessions and they need it there for your security and comfort. I think once it gets worse and worse and they become more embarrassed and isolate themselves when people say something is wrong with you, why are you holding all of these items? So they isolate themselves. Don't get help, but just isolate themselves.

Ted Simons: Even if a family member -- let's slowly get this place cleaned up. That can be a problem?

Linda Buscemi: Oh it absolutely can. It can end up loosing family ties too. What I would suggest is trying to get help. Especially if you're a family member who has a family member who is hoarding. To go in there and blast them with something is wrong with you, I'm going to clean this place up may not be the best idea.

Ted Simons: It sounds like the behavioral health community might be a little behind on this. Is this something new -- am I off base there?

Linda Buscemi: Not at all. The good things about the different stories and A & E and the discovery channel, its bringing awareness, but we're behind the eight ball. We don't have the exact treatments how to help these folks. We're a little bit behind.

Ted Simons: As far as the Arizona taskforce is concerned, talk to us about what you do and try to do.

Linda Buscemi: It started with code enforcement who recognized this was more than just say going in, you're cluttering and we need to move you. They recognized you end up going back to the same home. We all got together -- and trying to find resources to help folks. On our website, there are support groups. Come to our meeting, it's open to everyone of. The more the better. We can find something in Arizona to help these folks.

Ted Simons: Are these the folks that will get out of the house and go to these things? Or family members and friends?

Linda Buscemi: Mainly family members trying to get help.

Ted Simons: Do you see optimism. The behavioral community getting ahold on this?

Linda Buscemi: I do. I noticed more research and studies being done in the last 10 years. It's a good start.

Ted Simons: Thank you.

Linda Buscemi: Thank you very much.

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