1. “Too Much Stuff”

2. Hoarding Obtaining materials, failure to discard, accumulation of a large number of possessions. Obtaining materials, failure to discard, accumulation of a large number of possessions. Home is cluttered to the point where it becomes a safety hazard. Home is cluttered to the point where it becomes a safety hazard. Emotional/physical distress caused by the large amount of accumulated material. Emotional/physical distress caused by the large amount of accumulated material. Home is cluttered to the point where it is impossible to maintain its intended use. Home is cluttered to the point where it is impossible to maintain its intended use.

3. Only in the Media A four month search for a missing women came to and end when her husband found her corpse in their home amid the labyrinth of squalor. A four month search for a missing women came to and end when her husband found her corpse in their home amid the labyrinth of squalor. A hoarder was stuck in so much garbage and debris and junk that when she died, she had to be removed through a hole cut into the roof of the home. A hoarder was stuck in so much garbage and debris and junk that when she died, she had to be removed through a hole cut into the roof of the home.

4. Manifestations of Hoarding Acquisition Acquisition PurchasingPurchasing StealingStealing Free ItemsFree Items Saving Saving Clothes, newspapers, worthless, wornClothes, newspapers, worthless, worn Disorganization Disorganization ClutterClutter Mixed ImportanceMixed Importance BehaviorBehavior Churning Churning Out of sight fear Out of sight fear Attachments Attachments Sentimental Instrumental to their daily life Intrinsic value Data Data 55-90 target population Animal/Material

5. Animal Hoarding Mostly female Mostly female Mid 50’s Mid 50’s Single Single Socially Isolated Socially Isolated Mainly cats and dogs Mainly cats and dogs Ascribe human qualities to animals Ascribe human qualities to animals More closely attached to animals than people More closely attached to animals than people

9. Health Issues Associated with Hoarding Lack of Sanitation Lack of Sanitation RodentsRodents Transmission of communicable diseaseTransmission of communicable disease Unfit for human habitationUnfit for human habitation Safety Issues Safety Issues Blocked Entrance/ExitsBlocked Entrance/Exits Fire Hazards (homeowner/safety forces)Fire Hazards (homeowner/safety forces) Social Issue Social Issue Isolation from family societyIsolation from family society Afraid to ask for helpAfraid to ask for help They are aware of how others view their homeThey are aware of how others view their home

10. Cuyahoga County Initiatives Local Task Force Local Task Force Cuyahoga County Hoarding ConnectionCuyahoga County Hoarding Connection Developing a comprehensive database utilizing nationally approved tools (Clutter Image Rating Scale, Hoarding Rating Scale) Developing a comprehensive database utilizing nationally approved tools (Clutter Image Rating Scale, Hoarding Rating Scale) Developing a comprehensive database on existing city ordinances on health & safety in the home Developing a comprehensive database on existing city ordinances on health & safety in the home Working with communities already utilizing Standard Operating Procedure (Parma) Working with communities already utilizing Standard Operating Procedure (Parma) Comprehensive educational outreach to those community services impacted by the problems Comprehensive educational outreach to those community services impacted by the problems Develop a resource database listing those organizations available to help with cleaning, follow- up clinical treatment, manpower Develop a resource database listing those organizations available to help with cleaning, follow- up clinical treatment, manpower

11. Conclusions Hoarding disorder is common, chronic, and debilitating for individuals and their family members Hoarding disorder is common, chronic, and debilitating for individuals and their family members Hoarding is unique biological, cognitive, emotional, and behavioral features Hoarding is unique biological, cognitive, emotional, and behavioral features Traditional medications and treatments for OCD have not been very helpful Traditional medications and treatments for OCD have not been very helpful Need to further improve treatment to reduce overall impact and reduce clinical therapy Need to further improve treatment to reduce overall impact and reduce clinical therapy Design specific models to increase opportunities for care Design specific models to increase opportunities for care Sometimes you need to move fast and clinical intervention is not an option. Sometimes you need to move fast and clinical intervention is not an option.

12. Do you remember when pain was a symptom now it is a disease A GROWING PROBLEM A GROWING PROBLEM CHANGES OVER TIME IN OHIO CHANGES OVER TIME IN OHIO

13. Prescription Drug Misuse, Abuse and Overdose: The Epidemic – Ohio 1 Source: Ohio Dept of Health, Office of Vital Statistics 1

14. In 2007, unintentional drug overdose became the leading cause of injury death in Ohio, surpassing motor vehicle crashes and suicide for the first time on record. In 2007, unintentional drug overdose became the leading cause of injury death in Ohio, surpassing motor vehicle crashes and suicide for the first time on record. Prescription Drug Misuse, Abuse and Overdose: The Epidemic – Ohio * Source: ODH Office of Vital Statistics

15. Critical Key Messages Prescription drugs are safe and effective when used as prescribed by a doctor but can be dangerous and even deadly when misused or abused. Prescription drugs are safe and effective when used as prescribed by a doctor but can be dangerous and even deadly when misused or abused. Prescription drug abuse is a significant problem in Ohio and can affect anyone, regardless of race or socioeconomic status. Prescription drug abuse is a significant problem in Ohio and can affect anyone, regardless of race or socioeconomic status. Prescription drugs must be locked in a secure place when kept in the home and should be properly disposed of when they are no longer needed. Prescription drugs must be locked in a secure place when kept in the home and should be properly disposed of when they are no longer needed. Seniors have become a prime target for those interested in obtaining prescription medications illegally. Seniors have become a prime target for those interested in obtaining prescription medications illegally.