BY SUSAN M. KIRK
Firefighters constantly face new challenges. We want to do the most good for the most people, but in many of our local jurisdictions, the problem of hoaders is challenging our local agencies and prevention personnel. Hoarders have homes so overpacked with items that it is almost impossible to find an unblocked entrance or a means of escape should a firefighter find himself in trouble. Many times, we laugh about such homes and turn away, shaking our heads in astonishment. I have seen this firsthand and decided to further investigate them. Whether you call it a Collyers’ mansion, a pack rat nest, or just cluttered, it is still the same issue regardless of the geographical location (photo 1).
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Is it human behavior or a psychosocial issue? Hoarding is a mental disorder that stems from the fear of losing any item that may be needed in the future. This is common among the elderly, many of whom have survived the Great Depression when resources were scarce. This disorder can also be related to other psychological conditions such as obsessive-compulsive disorder, obsessive compulsive personality disorder, and attention-deficit/hyperactivity disorder. Since this may be a medical condition, the Health Insurance Portability and Accountability Act (HIPAA) laws can affect our ability to adequately mitigate this problem. There are many resources that we can use to address the medical side of this problem, but how can firefighters alleviate some of the fire dangers it involves?
Hoarding not only can create egress and ingress issues for evacuating occupants but also can delay fire crews entering the structure. Often, exits are blocked and rooms are filled to the ceiling with stacks of belongings that can easily fall over and entrap firefighters. Although firefighters may force open an inward-opening exterior door to enter, getting out through the same door may present a problem. Also, if a firefighter is in distress, accessing and removing him can be difficult (photos 2, 3). First responders have a double-edged sword to deal with—fire prevention and firefighter safety.
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THE FIVE LEVELS OF HOARDING
First responders must consider the five levels of hoarding to truly understand this problem and combat it.
1 Normal households with no large amounts of clutter visible, a couple of pet stains, and light evidence of rodents/insects. The doors and windows are accessible, and the home is maintained.
2 The household has large amounts of clutter, one exit is blocked, and pet odor and animal waste are present. There is light to medium evidence of rodents or insects, one household kitchen appliance or the air-conditioning unit has not been working for six months, and room functions are unclear. Also, there are overflowing trash cans, a moderate amount of dirty dishes and food on counters in the kitchen, household odors, and limited evidence of housekeeping.
3 The household has large amounts of clutter, items normally kept inside are outside, two or more appliances are broken, there are numerous electrical extension cords, and there is recent light structural damage to the home. There are multiple pets and pet waste with a strong odor, a light infestation of fleas, and audible evidence of insect or rodent infestation. Clutter is visible from the outside; there are only passageways through the rooms, hallways, and stairs; and one room in the home is no longer functional. There are small amounts of chemicals (e.g., household cleansers and insecticides, paint) or broken glass present (photo 4), a heavily soiled food preparation area, strong odors, soiled laundry throughout the home, and no evidence of recent housekeeping.
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4 Most doors and windows are blocked or inaccessible; the home has structural damage resulting from faulty weather protection; nonfood items are kept in the refrigerator, and papers are stored in the oven; the wallboard is damaged; and the electrical wiring is unsafe. The number of pets exceeds local limits by four or more, and there is obvious aged animal waste. There is flea, rodent, or insect infestation; and bats, squirrels, or raccoons are living in the home. Because the bedroom is unusable, the occupant lives in nontraditional living quarters in the home; and gasoline or paint is stored in living areas. There is rotting food on counters or expired or bloating canned foods; no linens are on the beds, or bedding is infested with lice; and there has been a long-term lack of housekeeping practices.
5 There is obvious structural damage to the home, broken walls, no utility service, standing water in the basement, hazardous materials, and large quantities of contaminants (e.g., fuels, acids, or other chemicals). Pets may be vicious and endanger occupants and visitors; and there is an infestation of insects, rodents, or snakes. All rooms including the kitchen and bathrooms are unusable; the occupant is unable to stay in the residence; and there is evidence of human defecation, rotting food, and multiple canned goods that are rotted or buckled.
FIRE PREVENTION
With each level of hoarding, intervention on behalf of the occupant becomes more intense and can involve many agencies. Fire prevention efforts will also have to change as we see an increase in levels of hoarding. Many of these persons will become angry and agitated if we move too quickly; within a short time, they will revert to prior behavior.
We must understand that the fire prevention tactics that we often use to encourage the community to install smoke detectors will not work in this instance. This condition has taken years to develop and may take a long time to modify. Often, just talking to the home-owner or occupant will not solve this issue overnight; it may take many return visits and consultations with several outside agencies to modify.
To address the fire prevention side of this issue, keep several things in mind:
- Hoarders may have other mental disorders that need to be addressed, so be prepared to contact other agencies such as the local area agency on aging, social services, the fire marshal’s office, the building code and zoning departments, local law enforcement, the health department, local psychological support groups, the sanitation department, and animal care and control. Note: Most fire prevention codes are not applicable to one- and two-family dwellings, unless specified.
- Discuss installing safety devices such as smoke and carbon monoxide detectors, practicing home fire evacuation drills, and occupant safety. Appeal to a person’s sense of safety and well-being of other occupants in the home, especially children and the elderly.
- Ask permission before entering the residence as required by law (it also gives the resident the feeling of control over the situation). Advise the individual you are there only because you care.
- Do not use sarcasm and negative tones when speaking to the occupants. Let them understand that this is a problem that can be overcome.
- Do not make negative remarks about the home or the occupants once you leave the location. As we all know in the fire service, word travels, and this will not help build a bond with the local community.
- Discuss solutions to the problem with the homeowner or occupants. Be willing to work with them and their families.
Working as a community, we can slowly chip away at this problem and reassure residents that we are there because we care and want to assist them. Some communities, such as Fairfax County, Virginia, and Orange County, California, have developed hoarding task forces to confront this problem.1,2 Some local departments have agreements with storage businesses to store a resident’s property until other arrangements can be made. Our department has found that when installing smoke detectors in homes, we have an opportunity to communicate to the resident the need to remove clutter for fire safety and identify these risk locations to other firefighters. As the community grows and the economy continues to downslide, we expect that this problem will grow and we will have to find new methods to battle this epidemic.
FIRE RESPONSE SAFETY
Firefighters continue to respond each day to fires regardless of the amount of personal belongings an occupant may have. Our tactics may change, but the need to put water on the fire does not. Firefighter safety today is a battle that all departments across the country continue to wage. Fires that begin in a hoarder’s home may require several new tactical decisions. Is it safe to send my crew in this residence? Is the fuel load so large that an interior attack may be futile? Can I even make access into this structure effectively? Are escape routes obstructed? Is it worth my firefighters’ life safety?
At Level 5 hoarding, a hoarder’s home may not be readily accessible, and occupants may no longer live there because the items hoarded have taken up all livable space. Items on the front porch or those blocking the windows may impede access. If windows are blocked and thus provide no entry from the outside, laddering such a residence would be pointless. Rescuing victims can also be challenging because they might be buried or blocked in an interior room. Many emergency medical service crews have responded to these locations and found patients who needed removal from windows or who were buried under items that tumbled to the floor.
Many homes look like ant farms, with only narrow pathways visible through the stacks of clutter. Basic search patterns will not work because there is no wall to follow for a right- or left-hand search. This situation may endanger crew integrity and the ability of the firefighter to remain oriented to his surroundings.
Because of possible insect or rodent infestation, responders should seal their turnout collars and coat and pants cuffs with tape. Moreover, they should remove and decontaminate their protective clothing before bringing it back into the fire station.
The fuel load in many of these structures is enormous and will fuel a much larger fire than a room-and-contents fire in an ordinary single-family residence. The water supply and the attack lines will need to meet this draw on resources. You will quickly have to decide whether you will fight this structure fire offensively or defensively. Key decision elements include the likelihood of savable occupants, the building’s structural integrity, how deeply the fire is rooted, how long it has burned unchecked, and the smoke conditions inside the structure.
During your initial size-up, look for clues that indicate that this is a hoarder’s home. Look for windows blocked by shelves or boxes, indoor furniture sitting in the front yard, an excessive number of pets, blocked doors, a heavy buildup of personal items on the front porch, and visible exterior structural damage to the home. Many of these homes will exhibit light to heavy structural damage resulting from numerous pets, insect or rodent infestation, the excessive weight of personal items, and the general lack of home upkeep.
The first-arriving officer must spot these indicators prior to making tactical decisions because they may alter his incident action plan. The size-up may also give clues to how long you may expect to remain on scene and the resources needed to mitigate the emergency.
Fighting a fire at a hoarder’s home will generally necessitate numerous personnel. The attack will be extensive and require a large water supply and possibly multiple hoselines. Any rescue efforts will be extremely taxing; overhaul and salvage will be incredibly difficult.
Keep in mind that to even begin salvage, a large number of items must be removed so that salvageable items can be removed from the fire area. At a deep-seated fire in a highly cluttered home, it can take hours to extinguish all the embers to ensure that rekindle is not imminent. Expect a deep-seated, smouldering fire deep inside piles and bundles of clothing and newspapers to suddenly intensify as it is uncovered and receives additional oxygen. Consider using Class A foam, wetting agents, or simply detergent to increase penetration into smouldering materials.
Consider the effects of water: Absorption by hoarded materials will add weight to a structure already burdened with an accumulation of items. The structural integrity may also be in doubt because of overloading and floors already weakened by leaks in the roof and plumbing.
Dewatering is another issue; dead rodents may be found floating in accumulated water.
Personnel should wear self-contained breathing apparatus during all overhaul and salvage operations because of the larger number of combustibles and the higher than normal presence of toxic gases because of the larger than normal amount of synthetic materials.
PREPLANNING
- Consider what social services and other agencies may be needed in dealing with a hoarding situation.
- Arrange for animal control response at homes with a large number of animals.
- Arrange for large trash containers for overhauled materials; monitor for smouldering to prevent rekindle.
- You may need heavy equipment such as front loaders to remove large amounts of debris.
As a community, we can deal with hoarding, and safer homes can emerge. It will take agency partnerships and a better understanding of the disorganized condition for first responders to overcome this obstacle. With this understanding, we can hope to execute better fire prevention and reduce our fire fatality rate. Overall, we can protect our firefighter and crews by training them to recognize this hazard before it endangers our safety.
Endnotes
1. Fairfax County (VA) Hoarding Task Force, http://www.fairfaxcounty.gov/code/hoarding/hoarding-task-force.htm.
2. Orange County (CA) Task Force on Hoarding, http://www.mhaoc.org/hoarding.
SUSAN M. KIRK is a Virginia-certified firefighter II and EMT-B and a 13-year veteran of the emergency services. She is a Virginia-certified fire instructor II, fire officer III, and cadre instructor in fire service training programs for several local jurisdictions. Kirk has developed a fire preplanning comprehensive countywide program and has sat on multiple committees to promote firefighter safety and survival.
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