Abstract
Hoarding is often described as a medical disorder, defined by a persistent difficulty in discarding possessions and associated high levels of emotional distress when forced to part with these. This article will discuss how having a different view of hoarding, seeing hoarding as a daily occupation which provides value, purpose, and meaning and with a relationship to self-identity and life purpose, could offer alternate interventions to support an individual who hoards. The article will consider the components of hoarding activity and how these relate to health and wellbeing and doing, being, belonging, and becoming as understood by occupational therapists. The article will consider what occupational therapy, a profession which considers a person's daily occupations, the things that occupy their time and which give meaning to their existence, could offer as an alternative to current hoarding interventions. Proposals for occupational therapy interventions will be suggested which would support occupational choice, support engagement in activities which have more positive outcomes on a person's health, and seek to address barriers which limit engagement and occupational performance in activities within the person's home environment.
Highlights
Occupational therapy aims to support a person’s health and wellbeing, incorporating the fundamental values and beliefs of the profession, in using meaningful and purposeful occupation as a vehicle to promote and sustain positive health and lifestyle [1]
Whilst it has recently been acknowledged that some occupations can be detrimental to a person’s health, safety, and wellbeing [2], there is a lack of occupational therapy literature to explore such occupations
Literature pertaining to hoarding and hoarding activity, including previous research on the management of hoarding and use of legislative powers, has been explored
Summary
Occupational therapy aims to support a person’s health and wellbeing, incorporating the fundamental values and beliefs of the profession, in using meaningful and purposeful occupation as a vehicle to promote and sustain positive health and lifestyle [1]. The understanding of hoarding as an occupation requires appreciation that this is an activity that is not necessarily socially acceptable to the public, and may infringe on their rights, but still has meaning and purpose to the individual who engages in hoarding activity. This allows understanding of “dark” or “nonsanctioned” occupations, appreciating that people will engage in occupations which challenge the sociocultural and health constructs which are more dominant in the population [9], but that these are still relevant areas for occupational therapists to consider to ensure practice upholds the occupational rights of all people and populations [10]. This paper will discuss how the beliefs of occupational therapy, the value and purpose of daily occupation, can be used with occupational science to reframe understanding about hoarding and from this propose how occupational therapy could offer alternative approaches and interventions to what are currently provided to support those who hoard
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