When a fire broke out in 58-year-old Sim Buay Piak’s Tampines flat last year, firefighters had to struggle to get through stacks of hoarded items that towered to the ceiling. When they finally got to Sim, it was too late to save the elderly man and he was pronounced dead by paramedics at the scene.
In 2019, at least two other similar cases of extreme hoarding have appeared in the news. One involved another elderly man in Bedok North who was discovered among mounds of rubbish only after a neighbour complained of a strong stench.
We hear of it only seldom. Yet the hoarding behaviour may be more prevalent in Singapore than we think. In fact, the Institute of Mental Health (IMH) estimates that one in 50 Singaporeans will display hoarding behaviour during their lifetime.
While it is the individuals that suffer from hoarding behaviour, there are potential ramifications for the community at large. When items clutter up at home and spill into shared corridors, they become an obstruction to neighbours, attract pests and in some cases, become a dangerous fire hazard.
Considering the potential harm caused to the individual and society, what can we do to help curb the phenomenon and how can we better support sufferers?
Spotlight on hoarding
Hoarding refers to an excessive acquisition of objects and inability to part with apparently valueless possessions. It has been classified as a pathology in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is known to manifest with other psychiatric conditions, such as obsessive-compulsive disorder and schizophrenia.
However, not all hoarding behaviour is pathological. As a field study conducted by Lin Sng Hock, a PhD student in Gerontology from the Singapore University of Social Sciences (SUSS) shows that the factors underlying the condition are varied and complex.
Many hoarders attach ‘saving’ and ‘sentimental’ value to the items that they collect. The ‘saving’ value they attach refers to their belief that the items will one day come in useful, and hence it would be wasteful to discard them.
As for ‘sentimental’ value, items take on heavy emotional significance, making it difficult for hoarders to throw them away.
There is also evidence that ethno-cultural factors may predispose people to think and feel this way. In Chinese culture for example, the emphasis on thriftiness normalises the behaviour of holding on to items that were achieved through hardship. Additionally, socioeconomic factors also play a role. Childhood deprivation and emotional insecurity born out of difficult livelihoods can manifest in hoarding behaviours.
One of the study’s subjects, an elderly lady, regards stuffed toys – which are still wrapped in their original plastic bags – among her prized possessions. She notes that growing up in a poor family meant her mother could never afford to buy stuffed toys. Hence, the plush toys she collected has grown in emotional value.
Seniors are particularly susceptible to hoarding tendencies as ageing often causes support circles of friends and family to shrink, leaving seniors in greater social isolation.
In Lin’s study, all the interviewees were living alone and had little to no social support to speak of.
Finally, hoarding is known to be a chronic and progressive condition – life events and ageing-associated factors may introduce stressors and increase the severity of hoarding.
As clutter builds up, hoarders are more likely to experience cognitive indecisiveness – paralysing them and their ability to decide what, in their vast collection, to discard.
Community-based approach to building awareness needed
There is more than one way to treat hoarding behaviour, and much of it depends on whether it stems from an underlying mental health issue. In such cases, treating the issue can sometimes reduce the person’s hoarding tendencies. For example, psychotherapy – specifically cognitive behavioural therapy – is increasingly recognised as an effective treatment.
However, if the underlying factors of poverty and social isolation are not treated, hoarders can very easily fall back into old habits.
This calls for a community-based approach aimed at alleviating these factors.
To this end, Singapore has established a Hoarding Task Force that brings together the expertise and respective powers of multiple agencies such as the Ministry of National Development (MND), Ministry of Health (MOH), Ministry of Social and Family Development (MSF), Housing Development Board (HDB) and Singapore Civil Defence Force (SCDF). Other agencies like the National Environment Agency, People’s Association, Institute of Mental Health and the Singapore Police Force will also play a part in this task force.
Led by HDB, which will be coordinating responses from relevant agencies, the task force relies heavily on grassroots organisations and volunteers to tackle the problem of hoarding. While it serves as a useful first port of call to report cases of hoarding, greater awareness among members of the community must prevail to bring more cases to light.
We should also look at the Habitat for Humanity Singapore, a non-profit organisation, which runs Project HomeWorks. The initiative is aimed at improving the living conditions of the elderly, sick and disabled in one- and two-room rental flats in Singapore.
They deal with two to three cases of hoarding every month, going in to check up on hoarders regularly and respectfully helping them to clear clutter. More resources could be channelled into a similar volunteer-run group dedicated to the issue of hoarding alone.
Hoarders need compassion and understanding to thrive
Clearly, hoarders do not engage in such behaviour with the intention of causing harm to others.
Hence, to help seniors with this condition thrive, we need to approach them with greater understanding and compassion, especially in our attempts to alleviate the poverty, isolation and loneliness underpinning their hoarding tendencies.
The path to helping people overcome their hoarding behaviours is one paved with great care and sensitivity. We can all play a part.
This article has been adapted from an end-of-course assessment: “Ageing in Multicultural Contexts” by Lin Sng Hock, a PhD student in Gerontology with Singapore University of Social Sciences (SUSS).