Animal Hoarding: A Serious Public Health Issue
- 1. Lecturer School of Nursing &Midwifery, University College Cork, Ireland
- 2. Department of Nursing & Midwifery, University College Cork, Ireland
Absract
Animal hoarding phenomenon, is often misunderstood, and typically involves the acquisition of a large number of animals. The homes of people who hoard animals tend to be cluttered, disorganizead and non-functioning and meet some hoarding criteria such as failing to meet care needs of animals. People who have undue attachments to animals, may see their role as saviors and may portray significant mental health concerns. Animal hoarding is an environmental and social problem that poses significant public health and safety risks on society, animals and economy. It is associated with extreme self-neglect, eviction, mental health issues, mortality and morbidity, behavioral issues and death of animals. Community nurses have a key role in the assessment and identification of clients who hoard animals. A person-centered approach, engagement with animal hoarder, negotiating and establishing, if possible, a relationship of trust, and empowering the client is key. This will contribute to risk assessment, coordinating multidisciplinary and cross agency responses to help reduce health and safety concerns. This paper provides insight into animal hoarding as a serious public health issue, and the role and contribution of nurses.
Keywords
Animal hoarding, Self-neglect, Animal neglect
Citation
: Day MR, McCarthy G (2016) Animal Hoarding: A Serious Public Health Issue. Ann Nurs Pract 3(4): 1054.
ABBREVIATIONS
DSM-5: Diagnostic and Statistical Manual of Mental Disorders; HD: Hoarding Disorder; AH: Animal Hoarding
INTRODUCTION
Animal hoarding is typified as: (1) having accumulated more than typical number of companion animals; (2) failing to provide nominal standards of nutrition, sanitation, and veterinary care; (3) failing or not acting or denial of the deteriorating condition of the animals (including disease, starvation or death) and the environment (severe overcrowding, extremely unsanitary conditions); and (4) unawareness of the negative effects on their own health and well-being, household members, and community [1].It is a serious public health issue that can have impact on the health, welfare and safety of individuals, families, communities, and the animals [2]. The hoarding of large numbers of animals ‘Noah syndrome’ has been identified as a variant of Diogenes syndrome, severe self-neglect [3]. Animal hoarding can create serious health issues resulting in many animals being euthanized [4]. Elevated ammonia levels from the accumulation of animal urine can be hazardous to both humans and animals [2]. The presence of numerous animals have been associated with selfneglect, environmental squalor and infectious disease [5,6]. AH and animal abuse is associated with child abuse, elder abuse, and domestic violence [7,8]. The American Psychiatric Association [9] has designated animal hoarding as a distinct form of mental illness. Animal hoarding is viewed as a subtype of Hoarding Disorder (HD) which is classified in the in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (300.3) [10]. In Chicago, a population based cohort study [11], of 4,627 older adults, reported prevalence for hoarding (objects and animal) among black (6%) and white (0.9%) population. The prevalence rate for hoarding of pets, in mild to severe self-neglect among Chinese population was 0.1% [12]. The American Society for the Prevention of Cruelty to Animals [13], (ASPCA) estimate that 900 to 2,000 new cases of AH are uncovered each year and annually 250,000 animals are victims of hoarding. A number of animal hoarding cases have led to criminal investigations and charges. These included Barbara Erickson and her 552 dogs [14], Swan Lady in Sweden [15]; and case where 140 dogs held in deplorable conditions in Ireland [16]. The prosecution of animal hoarders can negatively impact mental health issues. Furthermore there is a good chance that individuals who hoard objects will also hoard animals [17].
Types and models of animal hoarders
Several types of animal hoarding have been identified: exploiter hoarder; overwhelmed caregiver; rescuer hoarder; breeder hoarder and mission driven hoarder [18,19]. Animal hoarders can have extreme attachment to their animals and have grave difficulties in surrendering animals to others even when they are unable to care for them [20]. Exploiter hoarders often lack empathy toward people and animals and tend to have sociopathic characteristics. The care-giving role adopted by animal hoarders is framed in the need to rescue and save animals from certain atrocities [21]. Animal hoarding as pathological altruism is viewed as being connected to traumatic losses in early years [22]. A number of models have been cited as a way of understanding the characteristics of animal hoarders: addiction, obsession and compulsion, delusional, dementia, and attachment disorders. Animal hoarders share similarities with individuals who abuse alcohol such as obsessive concern with animals, denial of problem, excuses for the way they are behaving, assertions of persecution, personal and environmental neglect [23]. The attachment disorder model explicates animal hoarder’s preference for relationships with animals rather than humans [23].
Animal hoarders tend to lack insight and have no empathy with the gravity of the poor living conditions and welfare of animals thus supporting the dementia model [24]. Animal hoarding is a symptom of an underlying issue. Predisposing factors for developing animal hoarding are psychosocial stress, helplessness, loneliness, disappointment, early life experiences (neglect, abuse, poor parenting, and environmental factors), bereavement, loss, poor insight (deficits in metacognition), delusional, personality disorders and severe mental health problems [20].
Responding to animal hoarding cases
Animal hoarding cases require a multidisciplinary and multiagency response that may include Public Health Nurses, community nurses, social services, public health, environment and sanitation agencies, housing, veterinary, police, animal law enforcement, department of agriculture and others. The Henderson House work group noted poor communication between veterinary medicine, law and psychiatry in animal hoarding cases [25]. Collaboration among public health officials, veterinary services, law, and animal welfare agencies may reduce recidivism. The people who are more likely to hoard, live alone, have poor insight, and history portrays a chaotic childhood [18].
Assessment
Community nurses contribute to observation, assessment and identification of vulnerable adults who self-neglect, hoard animals or fail to care for animals and need to be proactive and attempt to engage with clients [26]. Elicit whether or not the person has the capacity to understand the health and safety risks for person, visitors, family, community and animals. It is a holistic assessment (physical, psycho-social and environmental) of individual needs, health and safety risks. This needs to include information on underlying psychosocial issues, centrality of animals to the individual, animal ownership: types and numbers, physical environment and animal welfare. Where there are large numbers of animals, identifying the relationships of the person to their animals is very important. Risk assessment and safety planning are a core function of nurse’s role (gerontological nurse, community/public health nurse, mental health nurse). A range of tools are available to support assessment such as Self-Neglect Assessment Measure [27]; Environmental Cleanliness and Clutter Scale [28,29]; Clutter Image Rating Scale [30], and Making and Executing Decisions for Safe and Independent Living (MED-SAIL) [31]. Building a therapeutic relationship with a client, involving them in decisions and positive risk taking may take several visits.
All of the above will inform responses and interventions and facilitate professional decision making [2].
Interventions
Interventions that target well-being of person, health, safety, and welfare of animals are important [32]. Cognitive behavioral therapy has shown success for animal rescuers. There is no data on drug therapy treatments for animal hoarders. Greater awareness and education on risk assessment and animal hoarding is needed for community nurses (gerontolgical nurses, public health nurses, mental health nurses). Animal hoarding cases can give rise to high costs and complex legal and ethical challenges regarding autonomy, choice, health and safety, lifestyle, mental capacity, property and environmental issues and animal welfare issues. The endangerment and risks posed by animal hoarders to family, community and animals, will affect responses and interventions. Many cases can result in prosecution and the law, legislation and jurisdictions varies among countries. Emotional fallout can arise when animals are removed. Animal hoarders who are irrational and awkward do not respond well to negotiation, and therapeutically orientated interventions. Community nurses, multidisciplinary team members, health and social care agencies and veterinary professionals, need to be aware of the human and animal health and welfare issues associated with animal hoarding. Early intervention can potentially reduce serious adverse outcomes. Community nurses and multidisciplinary team members need to be knowledgeable or be able to source expert knowledge on animal welfare laws, legislation and policy as it pertains to their country or state for addressing animal hoarding cases [8]. Inaction can have serious adverse outcomes.
CONCLUSION
Animal hoarding creates significant and complex risks for individuals, household members, communities’ environments, and animals. Greater understanding of animal hoarding has potential to improve the way professionals and agencies intervene and respond. Community nurses have a key role in risk assessment, identifying and recognizing animal hoarding disorder. Community nurses can contribute to greater interagency and interdisciplinary collaboration to harness a wide range of resources and expertise to improve quality of life of animal hoarders. Future research is required to examine the relationship between self-neglect, animal hoarding and abuse. There is a dearth of guidance available on how community nurses can work with animal hoarders.
There is a need for community awareness on animal hoarding.
