Situational Awareness in Hoarder Homes


Here is a Guest Post From Dr. Richard Gasaway's Website on Situational Awareness in Hoarder Homes.  Dr. Gasaway is a worldwide leader in educating first resonders in situational awareness.  Make sure to check out his website samatters.com

Because SAMATTERS......

 

I want to take this opportunity to introduce the Situational Awareness Matters community of readers to an associate and good friend of mine, Firefighter-Paramedic Ryan Pennington with the Charleston (WV) Fire Department. Ryan has been conducting extensive research on the epidemic problem of emergencies in hoarder homes. Emergencies including everything from fires to EMS calls to animal hoarding issues – the whole gamut. Ryan has also developed a knock-out program on hoarder home fires. If you’re jurisdiction is having problems with hoarder home fires, Ryan’s program may be just what you need. Let’s see what Ryan has to say in this guest article on “Heavy Content” Hoard Homes.

 

Good afternoon and welcome to SAmtters.com.  I would like to take this opportunity to speak to you, the loyal readers of SAmatters, on Hoarder House Fires.  Educating firefighters on the dangers associated with hoarder fires has become my passion, so when Chief Gasaway offered, I jumped at the chance to share a lesson in hoarding with you.  So let’s go into the chamber of hoarders for an article on using the term “heavy contents” while battling a Hoarder Homes fires.

Hoarder Home Size-Up

Situational Awareness Matters!The duty of the first arriving officer is to size up the situation accurately.  During this process they will use their senses to form a plan of attack by walking around the structure.  During your size up you will need to pay close attention to windows, front yards, porches, and entry ways for signs of hoarded interiors.  If you make this determination you need to announce “Heavy Contents” to everyone on scene and responding to tell them of the conditions.  It’s kind of ironic that I am writing about the use of this term for Dr. G’s website as he was instrumental in developing it.  You see he is the brain science professor that helped me realize the meaning behind these two terms placed beside each other.

The Origins of Hoarding

Situational Awareness Matters!We all have terms that we use to describe a hoarded home.  From “trash house” to “Collier’s Mansions”, a term derived from the Collier brothers in Manhattan. They made hoarding famous or should I say infamous. We have used multiple versions of describing the same thing. These words have the same meaning behind them but can be harmful to the owners of the homes if they are standing beside one of our radios when the report gets to command.  You see, people who live in hoarded conditions have an emotional attachment to their “stuff.”  A simple stack of newspapers to you might have a deep emotional meaning for them.  You can see how it might cause a problem if they overheard radio traffic describing their belongings as “trash” or their home as a “trash house.”  If you choose to use “Collier’s Mansion” terminology you will need to make sure that everyone who might respond to your scene has a true understanding of its meaning.

Heavy Contents

Situational Awareness Matters!That is why I developed the term Heavy Contents.  It is politically correct, accurate, and should trigger your brain to start thinking of the increased weight that is added to the structure, even before the first drop of water hits the ground. Hoarded homes often have so much stuff in them that normal living spaces become uninhabitable. If the belongings are occupying that amount of space imagine how much extra weight has been added onto the structure. This is where the term Heavy comes in.  A large amount of belongings equals a large amount of weight and it is a term that anyone can relate to, even if they haven’t been taught it, due to the use of common terminology.

Property Maintenance

Situational Awareness Matters!Another complication inside a hoarded home is the lack of property maintenance.  Hoarder conditions make it almost impossible to reach all the points of the structure from leaking pipes, busted ceilings, finding termites, or noticing a leaking exterior wall leading to weakened structural members.  This is troubling to us, as firefighters, due to the chances of structural collapse being increased, often without us knowing. This is just another reminder that if we hear the term heavy content called out that we should automatically think of increased collapse risks.

Piled High and Deep

Situational Awareness Matter!The second of the two words should warn you of the dangers that lie inside.  With hoarder homes you can face belongings that can reach all the way to the ceiling.  Add in a fast-moving fire with thick dark smoke and it’s a recipe for your death.  If you hear the call of heavy content you need to go to a defensive mindset.  Not so much that you need to abandon interior operations, although that would be a wise decision many times, but you need to be more careful in selecting your point of entry, hand tools, and absolutely do not enter without a thermal imagining camera and a hose or search rope to help aid in your exit. In a hoarder home the right and left hand searches are basically useless due to the inability to use the walls. Your only link to the outside is that hose or search line if your TIC batteries fail.

In closing I would like to thank Dr. G for giving me the guidance over the past 20 plus years and the chance to share an article on hoarder home fires with you. You should read this article, return to your department, and share the term “heavy content” with anyone who may respond to a hoarded home in an emergency. It should hammer home the importance that it’s not a basic fire anymore.  Hoarded houses can put you at a higher risk that needs to be identified and adjusted for immediately upon the discovery of heavy content’s.  Using a term developed with Dr. G’s brain science will hammer home to your people the need and hopefully make you remember this article.  Just remember that SA does matter and before you go into your next fire maybe you should spend some time reading Chamber of Hoarders (www.Chamberofhoarders.com) so you will be ready to face the Heavy Contents inside your next hoarder home fire.

Hoarder Home Podcast

Ryan Pennington will be a guest on my Leader’s Toolbox Podcast radio program at Firehouse.com next Wednesday. This is not a live program.  I will send out an announcement via my social media channels to let you know when it goes live, along with a link.

Hoarder Home Webinar

Ryan and I will also be jointly presenting a Webinar on situational awareness and firefighter safety in hoarded environments. The date will be announced soon on my social media channels. If this is a topic that interests you, please post a comment at the end of this article and send me a message on my Facebook Fan page or on Twitter. Thank you! Your participation is very important to the success of Situational Awareness Matters!

Chief Gasaway’s Advice

Situational Awareness Matters!Hoarder homes present special challenges for first responders, including fire, EMS and police. The hoarded environment is especially dangerous because of the heavy loads, the unpredictability of the contents and the limited ingress and egress. Hoarder home emergencies cannot be treated the same a non-hoarded homes. Thanks Ryan for taking the lead on this critically important topic.

Situational awareness starts with capturing clues and cues that are the foundation of knowing what is going on. In a hoarded environment, those clues and cues are going to be different – maybe even bazaar. There may be indicators outside the house (often there is) but you may not know it until you make entry and then get the surprise of your life.

DiscussionsSituational Awareness Matters!

1. Discuss hoarder home calls that you have been on and what you encountered that made the call more difficult.

2. Discuss the clues and cues that indicate the home is a hoarder home.

3. Discuss alternate strategies for getting your work done safely.
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Hoarding: Dealing with the Occupant’s

While  studying Compulsive Hoarding Disorder and the effects that it has on today’s first responders one common problem keeps coming up.  Dealing with the occupants of these homes can prove to be a challenging problem  if you  are tasked with an emergency inside their Hoarded Environment.

Interaction with the people who collect, accumulate, and acquire this massive amounts of belongings can place the first responder in a different type of danger. Physical danger from the anger that someone can experience when someone touches his or her treasured belongings.  Let’s look at a few common tactics to diffuse the tension and protect ourselves from the dangers faced when interacting with the people who hoard.

[caption id="attachment_248" align="alignright" width="134"]Photo Courtesy of Sheperdstown Fire Photo Courtesy of Sheperdstown Fire


Do not be judgmental

One of the hardest things to do as first reponders is to leave our values and opinions that we have established over the years behind when we discover a hoarding environment.  I have seen many first responders find these conditions and immediately become aggressive in telling the occupants that “this is the filthiest house ever” and “this place stinks” as they pull their shirt over their noses.

While this can be a very hard to resist it will put the occupant in a heightened state of sensitivity and can even evoke a response of anger or violence to the first responder.



By being non-judgmental and aware that hoarding is becoming a diagnosable physiological disorder we can further understand their deep attachment to their belongings.  Hoarding is not a choice and the inability to “let go” of their belongings that seem to have no apparent value to you and I can cause them be defensive and take offense to such statements if we were to make them.

Compulsive Hoarder’s have a hard time distinguishing between an object of great value, such as child’s baby pictures, and an item that has little apparent value, such as a stack of coupons.

This attachment may seem unimaginable by us but by understanding how they process this information can give us, the responders, the knowledge to be sensitive to their conditions when interacting with them.

Explain what is happening

While interacting with a person suffering from this affliction during the process of mitigating their emergency we have little choice but be direct sometimes, especially when dealing with a life or death emergency.

An example would be in the case of a medical emergency where we need access to the patient fast.  One problem with our aggressive nature is in the process of accessing the patient we may disrupt their world.

With the assigning of value to items folks who suffer from this also get angry at anyone who touch or “disrupt” their stacks of belongings .  If they watch you moving, touching, or tossing their treasures aside they can become angry with you and may even become violent.

One way of lessoning this potential is to explain your actions to the person in a sensitive manner before or during the actions.  Ma’am or Sir, I understand that this may upset you but we need to get you to the hospital as soon as possible, would be a direct statement to use in these circumstances.  While this is not an end all cure all it will help ease the tension felt by your patients in the case of removing them to an awaiting ems unit.

[caption id="attachment_159" align="alignright" width="134"]Photo Courtesy of Sheperdstown Fire Dept. Photo Courtesy of Sheperdstown Fire Dept.


Move them away

One type of response may require you to relocate the occupant to another location.  In the event of a fire, we may not have time to interact with the occupant. Before making this decision you will need to conduct an interview to determine if all occupants have exited the building, and which entrance do they normally use to access the building.

When hoarding takes over an occupancy it often blocks means of entry and exit causing the occupant to use a different means of access, such as a window or ladder.

Once the interview is over and the firefight has continued you may experience the occupant going through an emotional emergency.  Remember that as our firefighters are removing, throwing, and breaking through the piles of belongings the occupant sees you as hurting their treasured items.  Anger, yelling, or even physical violence can result due to their deep emotional attachment.  This is where we may need to involve neighbors, bystanders, or even the police department to help remove the occupant to insure their and our safety.  Understanding the nature of Compulsive Hoarding Disorder will allow us to understand their emotions when dealing with their stack of stuff.

 

Conclusion:

Understanding the complexity of Compulsive Hoarding Disorder will allow you insight into dealing with the men and woman who suffer from this disorder.  It has proven that hoarding can lead to a multitude of problems from health concerns to working house fires.  One problem that we should prepare for is interacting with the people who live inside these cluttered environments and develop some strategies to deal with the potential for danger to them and us. We are sworn to protect life and property our safety is always first on the list.  By safely developing a means of interaction with people who has this disorder will allow us to help everyone in and around the hoarded environment.
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Heavy Content =Not a “Normal” Fire

As I returned home from teaching the Heavy Content class to 25 firefighters from West Virginia and Ohio my phone began to ring.  “You will never believe this” was the beginning on our conversation.  Turns out that the Point Pleasant Fire Department, the host of the program, was dispatched on a confirmed working fire and they found Hoarding Conditions upon arrival.  It almost does not seem possible that they would find such a fire not more than 2 hours after sitting through the class.  Unfathomable, not really, if you think about the nature of fires in houses that have “Hoarding” or “Heavy content “inside.  Let’s take a quick review some of the more common traits found when faced with a Heavy Content fire.

Using a 380 Size up

Since taking on this topic of fighting fires in hoarding conditions I have proposed the use of a 380 degree size up, with the extra 20 degrees coming from looking in their cars.  Looking in their cars can give you a glimpse of what the interior of the house looks like.  Do I have any scientific data to back up this conclusion? Nope, but if it looks like a duck and quacks like a duck, it may be a duck. This is not a concrete identification factor but can lead a first arriving firefighter to suspect that the house is in the same conditions as their vehicle.  Read more Here Firehouse.com

The Structure can be weakened BEFORE the Fire

If the occupant suffers from the affliction of compulsive hoarding disorder and their collection of belongings has limited access to the load baring walls and ceilings identifying dangerous conditions can be hindered.  An example of this would be an event such as a busted water pipe.  The occupant has such emotional attachment to their belongings they are unwilling or unable to move their “stuff” to make the necessary repairs to the wall.  Often they will just shut the water off and not repair the damage.  This can lead to mold and rotting of the support system making the structure unstable even before the fire happens.

One example of this was shared where the side C firefighters attempted an interior push and noticed that the exterior wall had completely separated from the roof.  Beep, Beep, back the truck up!  This is a glaring example of why a 380-degree size up and expecting structural damage to be present once you identify the heavy content environment.   Will making this size up you should allow all firefighters to aid in the determination of instability and everyone should be in a defensive mindset from the beginning, realize that it’s not our fight, and hit it from the outside!

Call for help early

The biggest learning point for heavy content fires is the need for additional manpower.  Any first arriving firefighter who discovers hoarding conditions need to realize that the

[caption id="attachment_220" align="alignright" width="144"]Be Prepared For Overhaul Dangers Be Prepared For Overhaul Dangers


stress placed on the firefighters will be increased and needed rehab times will be longer.  What this means is that more firefighter will be needed to accomplish the task of putting the fire under control and an even larger amount will be needed once you transfer into the overhaul phase.  Stress kills firefighters, to reduce this stress in a Heavy Content environment we should call for help early.  It’s better to have a number of lawn shepherds in the area ready to do work than be pushing the crews who are already being pushed to their physical limits.

With hoarding comes some predictable findings.  These are just a few points that should be factored into any decision making process to make sure we all come home safe from fires in Heavy Content environments!  Let’s all join in the fight to make sure we all know what and how to keep our heads up and identify these firefighter dangers!
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Collapse risk in Hoarding Conditions

Welcome back in the Chamber of Hoarders! Now that our California trip is over it’s time to continue our mission of protecting emergency responders from the dangers associated with Hoarding.  One of the biggest learning points given when teaching this topic is the need to double estimate burn times and assume that collapse could happen at any time, why is this?  Many factors need to be considered if you are faced with hoarding conditions and structural stability is one of the biggest. Let’s take a look at small sample of the dangers associated with the collapse risks.

Lack of Maintenance

[caption id="attachment_248" align="alignright" width="224"]Photo Courtesy of Sheperdstown Fire Photo Courtesy of Sheperdstown Fire


 

Hoarding behavior in itself tends to add to structural instability as the occupants often feel “embarrassed” or “ashamed” about their disorder.  This will not allow them to let outsiders such as family or carpenters in to fix issues that occur as a part of normal household maintenance.  An example of this would be a busted water pipe that has been leaking for days. Most folks would take the time to pull drywall, find the problem, repair it and return it to service.  With hoarding conditions, the inability to access this problem is an huge issue on top of the fact that they will not allow a qualified construction crew into fix the problem.



Over time, the water will begin to rot away at the structural components that support the floors, walls, and/or roof.  This can put them in such a weakened state that they be in danger of collapse before the first drop of water is applied.  It can also lead to a false sense of security to the first arriving firefighters who may feel some give in the floor area and not suspect collapse could be crawling into a disaster.  Once you have made the discovery of heavy contents it should be automatically assume that the structure is in a weakened state.

Load Levels

It has been well documented that people that are afflicted with Compulsive Hoarding Disorder may assign a value to any type of object. From books and magazines to car parts, you may discover many different types of belongings hidden inside a home with hoarding conditions.  Making the determination of what is being collected will help an incident commander make a quick analysis of the potential for a life threatening collapse or the potential to NOT GO IN!

A good rule of thumb to keep everyone safe in hoarding conditions it to double the estimated burn time.  If you estimate it takes 5 minutes to discover a fire, 2 minutes to call 911, and 8 minutes to get water on the fire you should take this 15 minutes and assume that it has been burning for over 30!  This will put everyone in a defensive mindset even if you choose to go interior!

 

Structural collapse can be the most dangerous effects of a building on fire experienced by today’s firefighters. It’s our job to learn the cues and clues of a structural collapse.  It is even more important to identify hoarding conditions to make sure that we are not caught in a situation that was unstable before it caught on fire!

 

Be safe everyone and thanks for the visit to the Chamber!
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Go old School on Hoarder Fires

 

As the news came in from Maryland’s recent Hoarder fire, the images began to surface.  Their choice of High Expansion foam made for some amazing video.  The images looked like someone had put the bubble bath into a hot tub and left it on for hours.  Using foam while battling a hoarding condition can be one of the best solutions to the problem. One drawback is getting the foam on top of the piles of debris; this is where the high expansion foam comes in as it keeps filling the rooms until everything is covered.

 ]Cellar Nozzle

Cellar Nozzle


If you do not have access to this type of foam or foam at all, you may need to reach deep into your bag of tricks to pull out an oldie but goodie nozzle, the bressnan cellar nozzle! You know the nozzle that ISO has made sure we all have on our engines for years.  This type of nozzle has a great use in fighting hoarder fires.  The 360 degrees of water sprayed in small droplets will absorb heat and soak the entire area around it; one problem is how to get it above the hoard that is where we need to get creative.



 

Here are a few points in using a cellar nozzle:

    • Cut a vent hole in the attic and drop the nozzle down from the roof

 

    • Breach an exterior wall high, place through the hole

 

    • Use an exterior window and use an attic ladder to push it over the hoard.

 

    • Use a hook to push it above the hoard if inside the room



These are a few quick tips on using a cellar nozzle while dealing with a hoarder fire.  Notice one common point; we are not in the room when it goes in service.  A cellar nozzle uses the reduced airflow to “steam” the fire out. This attack has the potential to push your PPE to its’ thermal limit.  Today’s PPE has better thermal protection than ever but steam burns can be some of the most troubling.  Set the nozzle in place then back out before it goes in service to help protect from steam burns.  Once it has been operating for a few minutes watch for signs of knockdown such as white steam and changing smoke conditions and prepare to start the overhaul process.

[caption id="attachment_181" align="alignright" width="140"]Photo: Sheperdstown WV Fire Dept. Photo: Sheperdstown WV Fire Dept.


To add in the effectiveness of a cellar nozzle you should leave all the windows and doors in place as it will add to the steaming of the fire.  Thinking of hoarder fires as confined space fires with reduced airflow will put you in the mindset of using those types of tactics, especially if an interior push cannot be made. Just remember to review with your firefighters the need to pull out of a building if an interior push is blocked by hoarding conditions.  Back them out, grab the cellar nozzle, and get creative!  While it is in operation, you have time to order more resources and prepare to dig in!

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Behind those Doors..Could Be Hidden Hoarding

[caption id="attachment_15" align="alignright" width="300"] Photo Courtesy of sdfirephotos.com


Good afternoon from the chamber of hoarders.  The weather is turning nice and it’s time for the winter slumps to end.  It’s time to get out into your area to see if anything has changed, such as a hidden hoarder that has now been revealed.

A “hidden hoarding” is a person that has a hoarding condition that is ashamed or embarrassed  to have anyone inside their home because it is compacted with belongings.  They will keep themselves as reclusive as possible until someone stumbles upon their hoard.  Often the first people to discover this are emergency responders.  If the person has a medical emergency, fire alarm, or possible trespasser the call is sent to the proper public service branch.  We they call 911 we rush to help then find a hidden truth.

 

Often when a home reaches its maximum capacity the hoard will spill out into the yard, garage, car, or porch area.  During the winter months the hidden hoarders will become exposed as they make room to heat their homes thus making it visible from the exterior the conditions inside.  As you make your way through you may just happen to notice something that might cue you in to the hidden hoarding,exposing what is lurking inside.  We are not permitted to enter a private dwelling it is  only speculation, but it can also be an educated guess.

 

If you suspect it you should share it!  That’s right, if you highly suspect someone possibly be a hoarder what good is the information if you’re not on the call? If you suspect that hoarding conditions possible is present you should send an email, text, or write something on your stations chalk board to warn the other crews that there is danger behind the doors.  I have been in the fire service for a long time and one thing seems to stay constant.  A lack of inter-departmental  communication, I’m sure that this doesn’t apply to all of you but I will take a stab that it pertains to some.  Take the time to share your suspicions with the other members that behind those doors might be a HOARD.

 

Thanks for taking time in the chamber, keep your eyes open for more exciting information here at Chamber of Hoarders.com……
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