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A scoping study of support needs for older people who hoard in Canterbury

A 2019/2020 Summer Studentship research project

This research will help us understand the local context of support for people who hoard, compare this with best-practice, and prioritise the key steps for building future capacity.

Student: Otis Williams
Supervisors: Dr Susan Gee, Ms Tracey Hawkes, Dr Matthew Croucher, Ms Anna Williams
Sponsor: University of Otago, Division of Health Sciences

Introduction

People who hoard acquire excessive amounts of ‘stuff’ which they have difficulty discarding. This accumulation can lead to clutter living spaces unusable; causing risks to health and safety; giving rise to distress for the individual and their supporters; and leading to functional and social impairment. Significant (pathological) hoarding is most common in later life and can arise from biological factors, such as neurological conditions affecting executive functions; psychological factors, such as personality style, distress, and mental illness; and social factors, such as loss of social connections and/or a life-partner (Yeats, 2013).

Working with people who hoard is complex and establishing trust is challenging. Forced clean-ups can be traumatising and are generally ineffective with high relapse rates. Significant hoarding is ideally managed by a multidisciplinary team. Some jurisdictions have specialist teams and programmes (Frank & Misiaszek, 2012) but this is not the case in Canterbury. An exploratory 2019 gathering of Canterbury stakeholders identified concerns about the current capability of health and social services to assist people who hoard.

This summer studentship will engage with stakeholders and the literature in relation to best practice for supporting people who hoard to enunciate how Canterbury services might best build their capacity. (Dverka et al., 2013, NSCM, 2016).

Aims

  • To elicit and summarise the perspectives of people who have knowledge and experience of hoarding in Canterbury
  • To review the research and grey literature to investigate what others have done that Canterbury services can learn from
  • To identify Canterbury stakeholders who are interested in longer term collaboration to improve services for people who hoard


Method

  • Discussions will be held with representatives from each of a range of stakeholder groups:
  • People who hoard and their support people,
  • Service providers, including home-based support and community services, both primary and secondary,
  • Purchaser / policy analysts,
  • Emergency services, and
  • Advocates

A semi-structured facilitation process will cover the participants’ experiences with hoarding, what they have found useful or not useful, and what they would wish for the future. The discussions will be audio-recorded and transcribed. A framework approach analysis will be used to identify relevant themes (Pope et al, 2000).

The second arm of the project is to conduct a preliminary assessment of the relevant research and grey literature on best practice approaches to supporting people with significant hoarding, including describing New Zealand materials and services.

An accessible scoping report will be written and shared with stakeholders both in Canterbury. This will review the key insights from the study, identify available resources, and outline what initiatives might improve the Canterbury sector’s capacity to support people who hoard.

Student researcher’s component of the study.

  • To interview 2-6 people with experience of hoarding or supporting someone who hoards. These interviews with community participants will be conducted by one of the supervisors as experienced researchers / clinicians
  • To engage with 6 to 12 professional stakeholders in 1 to 3 focus groups, which would be run by the supervisors supported by the student. The student may also be involved in a small number of interviews with health professionals who can’t attend a focus group
  • A rapid literature review, for which the student would accumulate the literature under supervision

How to apply

Email susan.gee@cdhb.health.nz