There were hundreds of Meals on Wheels containers — dozens of empty ones stacked together, and others, still with food in them, packed into the fridge and placed in piles on the kitchen floor. At some point it appears the woman's toilet had stopped working, so she had started using a cardboard box, which was by then overflowing with paper and faeces.
The home of a year-old woman from the Caulfield area who had been living in squalor. Severe domestic squalor is not a distinct medical condition, but rather is described as a living environment that has become so unclean, messy and unhygienic that people of a similar culture would find cleaning and clearing essential.
Over the years there have been various theories on what causes squalor — including that it was linked to personality disorders. Husband and wife team Steven Penn and Lorinda de Regt-Penn run a forensic cleaning team that works in squalid properties. Credit: Simon O'Dwyer. But a recent Australian study, the largest of his its kind, has come to a new conclusion that has huge implications for how cases of squalor should be treated.
It tested 69 people living in squalor and found almost all the participants had frontal executive dysfunction. Brain damage, in other words, through dementia, head injury, alcohol abuse, stroke and other causes. Rubbish piled up in the house of an elderly woman in the Caulfield area. Her family had no idea of the conditions. The Melbourne researchers believe people's indifference to their living conditions stems from that damage to the frontal part of the brain, which controls planning, self-control, social interaction, judgment, problem solving and, crucially, insight.
It may be a hard to believe that a person living amid their own excrement would not realise there was something wrong with that. But that is exactly what typically happens in many cases of squalor — they don't see what others see. In trying to explain this absence of insight, the study's co-author Associate Professor Steve Macfarlane recounts his first squalor case.
The patient was an animal hoarder living in country Victoria who had become unpopular with his neighbours by rattling up and down the street at 3am with a shopping trolley full of cans. The man's eight cats would go to the toilet in the house. His solution, which he considered perfectly adequate, was to cover the droppings with kitty litter and leave them there in piles.
The cat hoarder had congenital hydrocephalus, a swelling of the head through the build-up of fluid in the brain. Squalor does not just appear overnight, but develops over many years, perhaps decades, in layer upon layer of food left to rot, spider webs that thicken in corners and all manners of animals that come and go. Some of this inaction is driven by a view that people should be free to live the lifestyle of their choice, or in some cases, an unwillingness to interfere or be impolite.
Steve Penn and Lorinda de Regt-Penn, a husband and wife team behind forensic cleaners TACT Bio-Recovery, once visited a Melbourne unit where the owner had incrementally filled the whole bathroom, above the height of the toilet, with used panty liners. Mr Penn said the lady living in the flat had asked her neighbour whether she could smell anything when she walked past.
They had lived side by side for odd years. Professor Macfarlane said people in putrid living conditions had often been managed by "well-meaning service providers" for many years.
However, the newest research suggests it is no longer acceptable to tolerate squalor as a "lifestyle choice". It is important that he or she begin to receive regular visits from a caregiver, preferably a trusted friend or family member. This can be a difficult task, because many Diogenes sufferers resent outside interference and will actively oppose attempts to help them.
Recovery from Diogenes syndrome has occurred but relapses to old ways are frequent. Helping a loved one with Diogenes syndrome can be a challenge. Just remember: the caring providers at Baptist Health are on your side. Give Research Contact. What Are the Symptoms of Diogenes Syndrome?
The following symptoms are typical of someone with Diogenes syndrome: Poor personal hygiene, including body odor, rashes, unwashed hair, untrimmed nails, and malnutrition Unsanitary living conditions, including undisposed trash or garbage, rodent and insect infestations, and odors of rotting food and other forms of decay Cluttered and disorganized surroundings that result from hoarding Unawareness of and a lack of shame regarding current living conditions Adamant refusal of offers for assistance or medical care There are two forms of Diogenes: primary and secondary.
What Causes Diogenes Syndrome? The following risk factors appear to apply: Old age Living alone, due to divorce, abandonment, or death of a loved one A tendency toward introversion and social withdrawal History of mental illness Dementia Damage to the frontal lobe, the decision-making center of the brain Alcohol or drug abuse The latter is a particularly important factor.
How Is Diogenes Syndrome Diagnosed? How Is Diogenes Syndrome Treated? What Are the Complications of Diogenes Syndrome? Does It Ever Get Better? But the hit show also highlights Diogenes syndrome, a disorder characterized by self-neglect, domestic squalor and social withdrawal. The eccentric Beale pair -- the first cousin and aunt of Jacqueline Kennedy Onassis -- is a classic example of what has also been called squalor disorder, which especially affects the elderly. The syndrome was named for Diogenes, a Greek philosopher of the fourth century B.
Hoarding occurs in about 1 to 2 percent of the population, according to Randy Frost, a psychology professor at Smith College who wrote "Buried Treasures," a self-help book for hoarders. Those who live with the syndrome manifest personality traits like reclusiveness, suspiciousness, obstinacy and other isolating tendencies.
There are often precipitating events -- such as physical illness, deafness, blindness and bereavement -- that make the syndrome worse. Research shows a relationship between the syndrome and anxiety and depression, and anecdotal studies suggest the disorder may be triggered by a significant emotional or relationship loss, said Frost. Hoarding -- which is also seen in dementia and mental retardation -- is also associated with obsessive-compulsive disorder, and that can start as early as the teenage years, Frost said.
A Web site devoted to this disorder -- Squalors. Those with the condition are often exploited by others. Last year, Milwaukee city health officials cracked down on landlords -- some paid by the city -- who were renting squalid homes to the mentally ill after the local newspaper exposed abuses.
There was a rash running up and down her legs and she was eating moldy food that the landlady had retrieved from the garbage cans and was serving people. Violations included infestations of rats, mice and roaches, no heat, no fire alarms, broken toilets, exposed asbestos, raw sewage backing up into the sinks, no running water, broken door locks and windows painted shut.
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