Culpeper County Emergency Services Lt. Bill Ooten vividly remembered being dispatched to a local home for a potential DOA, and the extreme hoarding situation he encountered upon arrival.
“I opened the front door and the items were waist deep,” he said.
The home was dark because stacks of possessions mixed with garbage blocked natural light from coming through the windows and the electricity had long since been turned off. Ooten, holding a flashlight, started hearing noises.
“The noises were rats. We could also hear roaches crawling on the walls,” he said. “But we couldn’t stop — we had to make our way and find this woman.”
It took Ooten and a partner about 10 minutes to find the elderly occupant of the hoarded home.
“She had passed away,” he said. “She was buried in trash. We had to dig her out to assess a pulse.”
On the job with EMS for seven years, Ooten said that call remains his most traumatic.
“It was intense,” he said.
Ooten was one of three featured speakers at last week’s free seminar on late life hoarding hosted by the Culpeper Committee of Aging Together in the community room at the police station. About three dozen attended the timely class about a topic popularized by such TV shows as TLC’s “Hoarding: Buried Alive.”
Hoarding is a mental illness marked by an individual’s compulsive acquisition of and failure to discard of useless possessions, resulting in living spaces so cluttered that using the rooms as intended is impossible, according to presenter Alan Rasmussen with the Rappahannock-Rapidan Community Services Board.
Hoarding causes a significant impairment in a person’s ability to function within their own home, often leading to no power or plumbing, unsanitary conditions and vermin and insect infestations.
Hoarders mix garbage with valuables in random piles, Rasmussen said, forcing each item to be sorted during a clean-up. He said his own mother, suffering from dementia later in life, displayed hoarding tendencies and would hide cash in old magazines.
Hoarders have a very difficult time getting rid of anything, Rasmussen added, and the illness is very averse to change.
“Indecisiveness is a hallmark of hoarding,” he said. “If they can’t make a decision, they’ll just keep the item.”
Individuals suffering from the mental illness also engage in something called “churning,” Rasmussen said.
“They keep going through things, but never throw anything away,” he said.
Hoarders often suffer from obsessive-compulsive disorder and social anxiety leading to isolation and depression. The behavior typically begins in childhood and impacts people from all walks-of-life. Hoarders don’t have much insight into their own behavior, Rasmussen said, and have trouble understanding others’ concerns.
The behavior creates grave health and safety issues, he added, including fire hazards and structural damage. It also makes it very hard for EMS to get to patients.
Lt. Ooten and fellow firefighter Pete Read talked about the difficulties they encounter – more and more – in accessing hoarded homes in times of emergency.
“This happens in Culpeper County in more instances than people believe,” Ooten said.
In emergencies, every second counts with everyday complications potentially delaying EMS access to the patient.
“Hoarding is one of the most difficult and dangerous obstacles,” Ooten said.
Read displayed the various pieces of equipment a typical EMS crew needs to get into a house on an emergency call including several large packs and an 81-pound stretcher.
“Getting a stretcher into a house is difficult anyway,” he said. “With clutter piles, it makes it that much more difficult.”
All while trying to maintain sanitary on-site treatment, Read said he has encountered falling trash and falling feces in hoarded houses.
“You just have to keep on going,” he said.
Added Ooten, “I can’t wait — I have to do something in a hurry to get to the patient. These are the conditions I have to work in, and again, we see it a lot.”
First responders are mandated to report hoarding situations to adult protective services, he said, noting their first concern is helping the person in need. It’s not just the elderly, Ooten added, describing his response to the apartment of a 40-something female.
“She had 30 or 40 cats and never cleaned the boxes,” he said.
In another case where the home had inoperable plumbing, buckets of human waste were piled up all over, including next to the stove where a woman was cooking bacon.
“I’ve seen it get worse in Culpeper County the past two or three years,” Ooten said. “People don’t help their neighbors anymore,” he added. “I attribute a lot of the hoarding behavior to that.”
In attempting to help a hoarder, Rasmussen said, never do a surprise clean-up, and don’t expect miracles to happen overnight. Work at the individual’s own pace, he said, while focusing on fire and fall prevention.
“De-cluttering a hoarder’s home can take hundreds of hours,” he said, and it can be quite costly.
Recruit volunteers to help out, Rasmussen said, like a church group or a local sports team.
“Do not belittle the hoarder,” he added. “Show empathy, be supportive and praise them often.”
Rixeyville resident Kathy Ellis attended the hoarding seminar out of a desire to learn more about the mental illness that claimed the life of her cousin, living out of state. He committed suicide after local government officials forced a clean-up, she said. Ellis said her cousin was never offered any mental health services, and many of his items were moved to a storage unit that he could not access because he didn’t drive.
“He was very lonely,” she said. “Everything in his house represented his family. I cannot emphasize strongly enough the need to handle this in an empathic way. What happened to my cousin was unnecessary and tragic.”
Northern Virginia professional organizer Maria Spetalnik addressed the local crowd about the cost and effort associated with hoarding, saying it impacts all aspects of a person’s life.
“You just keep getting in this downward spiral,” she said. “Don’t ignore it. It can happen to anyone. A lot of times by the time I am called, the entire family has left that person.”