Dealing with the challenges presented by compulsive hoarding disorder is assessing how IMG_1008bad the conditions are.  When families reach out for help with a family member the mental health professionals start the treatment process with an assessment of how severe the hoarding conditions are.  There are different hoarding assessment scales available to use when assessing the severity.  As first responders we need an common scale to use when hoarding conditions are discovered.  Using common terminology to describe the severity and danger will allow the dangers communicated effectively, accurately, and evenly.

Keep the assessment simple and straight forward is key during this process.  For that reason we recommend using the Institute for Challenging Disorganizations scale that rates all conditions on a 1-5 level.  Using this scale will allow the discovering agency to give a slight problem a one and the most severe a level 5.

As first responders this scale can be adjusted for the dangers we face.  This rating scale should be used by all first responders, utility workers, and anyone tasked with entering the environment to answer an emergency or service call.

Fire Service Hoarding Scale


Level 1: The start


•             Most of the homes that we see fires in seem to be at least a level 1 home.

•             With Level 1 you will not encounter large amounts of materials but may find normal clutter with some apparent signs of insects or rodents.

•             At a level 1 all doors, windows, and hallways will be accessible.

Level 2: Build Phase


•             In a Level 2 hoarder home the amount of overall clutter has begun to appear.

•             This is the point where you would consider the amount of belongings to be over and above a “Normal Level”.

•             Trash cans over flowing, one or more exits may be blocked, and housekeeping is at a minimal level.

•             At level 2 the piles of belongings may be at or above waste level.

•             Windows are starting to be unusable as the piles continue to get larger.

 

Level 3: Big Problems Begin


•             The amount of belongings has taken control of the house and making the rooms unusable for the occupants.

•             At Level 3, the amount of clutter becomes a serious hazard for firefighters.

•             The “Goat Paths” become the only access to the small areas of usable space.

•             At Level 3, the clutter may be visible from the exterior.

•             Noticing the windows and the level of belongings being above the lower sill, if not covered completely will be a prime cue or clue that a hoarder condition is present.

•             In a Level 3, the stairwells are mostly blocked with belongings.

•             Most Level 3 homes pathways are open to all rooms they are just narrowed down to a path.

Level 4: Beginning of the end


•             The beginning of the end of the useable areas of the hoarder home starts in level 4.

•             With most of the rooms at an “unusable” hoarded level the living space is reduced to small pockets of living area among 1 or 2 rooms.

•             The piles of belongings will be at ceiling level and all but most entrances will be inaccessible.

•             All windows will be covered, while the hoarder begins to find more ways of storing more belongings in these small spaces.

•             Attic spaces will be full; all cabinets will be full, even under the floor spaces may be used to amass the huge amounts of belongings a level 4 will collect.

 

Level 5: Uninhabitable


•             Unable to enter!

•             There is obvious structural damage to the home, broken walls, no utility service.

•             All rooms including the kitchen and bathrooms are unusable; the occupant is unable to stay in the residence.

 

This scale should be used in a pre-planning phase of operations.  It allows a common terminology and assessment scale to be shared between first responders.  Stay tuned for more assessment processes to share the discovery of Heavy Contents with all first responders.