Do Something

I came across this article last weekend, in the Guardian, about a man, Gordon Stewart, who was a ‘hoarder’. It goes beyond the common definition of ‘hoarding’ though and becomes a major and almost life-threatening degree of hoarding and collection of everything from ‘bits and pieces’ to actively collecting rubbish from outside.

That article, and a post written by Worker of Miracles a couple of weeks back now when s/he  mentioned a similar, if less dramatic situation.

It is something I have come across a few times and I wanted to elaborate on a particular instance which is now, going back maybe, 4 years at least and had a surprisingly satisfactory ending. I’ve changed the details for the sake of anonymity but the general thrust of the story is true.

Mr and Mrs A lived in a large council street property. They had brought their family up in this lovely 3 bedroomed home and a garden. But they hadn’t and when the children moved out, they had remained in the property.

Mr A was significantly older than his wife. His physical health deteriorated fast. Mrs A was always a hoarder. As she grew older, she moved from collecting things from charity shops, to collecting things from other peoples’ dustbins.

We (social services) were alerted to the need for assistance when a neighbour of the couple reported to Environmental Health that she had found a mouse in her baby’s room. The source of the mouse infestation was the property of Mr and Mrs A.

I was dispatched to ‘offer support and assess needs’. They were amenable, pleasant and friendly. They didn’t want any help though. I saw dead mice all over the lounge. The flat was so full of mice that I had mice running over my feet as I sat down. Mr A didn’t want to do anything that would upset his wife but I had a sense that he would be happy to access assistance. She saw it as an admission of failure as wife and carer. And continued to bring in the rubbish from the neighbours’ bins.

Environmental Health needed to arrange a clean. We offered Mr and Mrs A another property to live in but they didn’t want to move or leave.

I went with Rentokil  (pest control) to visit. The man from Rentokil gave me lots of useful information about how rats and mice don’t live together in properties so having mice at least meant there weren’t rats. There was also an infestation of some kind of beetle but I didn’t investigate that one too fully. He said it was the worst infestation he had seen in a domestic property for over 20 years.  I wondered what kinds of infestations he might have seen in other commercial premises.. but didn’t wonder too much as I wanted to be able to eat my dinner.

We explored the use of Section 47 of the National Assistance Act which states

Section 47. National Assistance Act 1948
3. Section 47 makes provision for the removal to, and detention and maintenance in, suitable premises of persons in need of care and attention. It enables a local authority with responsibility for implementing public health legislation (generally a district) to seek an order from a magistrates’ court for the removal of a person from his home on the grounds that:
a) he is suffering from a grave chronic disease or, being aged, infirm or physically incapacitated, is living in insanitary conditions;

b) he is unable to look after himself and is not receiving proper care and attention from anyone else; and

c) his removal is necessary in his own interests or for preventing injury to the health of, or serious nuisance to, other persons.

This seems to be fulfilling these criteria but there are two problems with this section. Firstly, locating and identifying the ‘medical officer’ who makes the application but more importantly, this law now contravenes more recent  Human Rights legislation.

We, in the end,  arranged for Mr and Mrs A to go to a local day centre – the environmental health team would go in to the house during the day – and leave by 5pm at which point Mr and Mrs A would stay overnight – to go to the day centre again the next day.

Soon after this ‘clean-up’, they were rehoused near other family members. Why the move was agreed after the clean up whereas it was so vehemently declined previously, well, my only attempt at a guess could be that the process of the removal of things had made the home seem less like a home and more where a public agency can enforce access to.

We get a lot of calls asking us to ‘do something’ about various people who are seen to be needing assistance but really there can sometimes be an issue of lifestyle choice.

On other occasions, it is more than ‘lifestyle choice’. Although I have no great expertise, my common rule of thumb is an indication of the past. If someone has lived like this for years, then fair enough – actually, there is very little that can be done until environmental health might get involved and that only happens when others are affected.

The Mental Capacity Act (2005) makes it clear that ‘unwise decisions’ are not an indication of a lack of capacity.

If it is a changed situation where it had a clear start point – a fall, a broken hip – that is more indicative of help being needed. But even then, nothing can be done without consent or an established lack of capacity and a decision made with the best interests of the person at the centre.  Even in those situations, it is impossible to read minds or have any more information than that which is given or available.

It isn’t always as easy as it sounds or seems to ‘do something’.