People of all ages, including children, may exhibit hoarding behaviors or live in poverty. You can live in any type of apartment, housing situation or environment. Or by a loophole in the law. Thanks to West Sacramento police and a squatter who dropped off the address with his probation officer, police were able to get inside, issue a warrant and remove the rest. It is rare for primary care physicians to receive referrals for hoarding and misery, but it is important that they know how to investigate the severity of hoarding and misery, as well as the risk to safety and assessment and referral pathways. Hoarding and misery are complex conditions with different underlying etiologies. In both cases, there is an accumulation of goods or garbage. The procedure is recommended because of a risk to the health and safety of the person or others. Gross domestic neglect describes a home that is so impure, disordered, and unhygienic that people with a similar culture and background would consider complete cleaning and purification essential.17 It is not a diagnostic unit in current classification systems, but an epiphenomenon of other diagnoses. There are two main routes to misery: domestic neglect, such as not removing garbage, and hoarding, such as excessive accumulation of objects.1 Misery (or “severe domestic misery”) refers to unsanitary conditions in the family. Misery is more common among older adults who have additional mental health problems, such as dementia. Misery can sometimes occur as a result of Huntington`s disease and sometimes without Huntington`s disease.
In Huntington`s disease, misery occurs when rescued items contain spoiled food and/or when animals are present. In many cases, misery results from neglect of normal cleaning activities. For moderate to severe hoarding and misery, referral to specialized psychiatry, geriatrics and related health services is recommended for further assessment, treatment of underlying conditions, and ongoing treatment. Potential Damage and Safety Risks: Assessing the Consequences of Hoarding/Misery: Severe hoarding disorders and misery are complex and difficult to manage. These conditions can often be debilitating for an individual and their family. Health workers and social workers who provide care often feel overwhelmed. Hoarding and misery can lead to violations of health, housing and hygiene laws. A multifunctional and multidisciplinary approach is often required. Medical, social and ethical dimensions should be considered and, ideally, clinical and environmental assessments should be conducted. The majority of people living in extreme poverty also suffer from a psychiatric disorder (Box 3),1 but only half of them have had contact with a mental health service in the past year.3 People living in extreme poverty may be malnourished and mortality is high.21,22 This article describes some of the laws that can be used to treat people living in extreme poverty. It can be used to force the purification of misery for the benefit of the individual or his neighbors.
Although hoarding and misery may sometimes seem similar in the family environment, they are two different, though sometimes overlapping, conditions. Hoarding disorder is a mental illness, while misery describes an unhealthy living environment that can be the end result of extreme neglect or hoarding at home.1,2 A quarter of people with hoarding and misery have a physical health problem that contributes to the state of their living environment. such as incontinence, immobility, or severe visual impairment.3 Contributing Conditions: Assessing the Factors Underlying Hoarding/Misery and Possible Comorbidities The legal definition of an unhealthy living environment can vary from state to state and even from county to county. However, in general, these definitions may include, but are not limited to: Environmental severity and symptoms: Assess and document the level of hoarding/misery – take pictures if the person allows, or use validated tools such as the Environmental Cleanliness and Congestion Scale (ECCS), the Footprint Image Rating Scale (CIRS), the Hoarding Rating Scale (HRS). Legal and ethical issues: Assess the person`s ability to make decisions about hoarding or misery. Are there any other legal considerations? For example, does the board or another organization have the authority to override the wishes of the individual? Consider the person`s willingness to change and safety risks, as well as the ability to refuse treatment versus the risks.