Chapter One

Hoarders: When People Can’t Part With Anything

Most of us are aware of the television shows that illustrate the phenomenon of hoarding. After conducting more than a hundred visits to the homes of hoarders, I believe that this is a simplistic view of an extremely complicated problem.

Hoarders can be male, female, young, old, of any nationality or socio-economic status. Even your good friend or co-worker could be a hoarder without anyone knowing it. People who appear to be fine on the outside may, in fact, be deeply ashamed of the condition of their homes or the way in which they live. Hoarding manifests itself in many different ways. There are homes with stacks of television sets, outdated VCRs and stereos. There are kitchens with an over-abundance of toasters, microwaves, food, empty jars and garbage bags. There are rooms with ten umbrellas, bags of clothing, an excess of pillows, five grocery carriages—the list goes on and on.

When we visit the homes of hoarders, we assess the environment and try to get our clients to explain their reasons for hoarding. For example, a client might say, “I have five grocery carriages because I will give them away to people who might need them,” and, “I collect old television sets to fix them so I can sell them to people who need them, or to a store that sells television sets like Best Buy.” Clients almost never do what they promise and their stockpiles keep growing.

Often hoarding begins as “collecting” and then takes a turn for the worse over time. This can be after months or, sometimes, even years. A hoarder may want to save all possessions, despite how insignificant the items may appear to others. Some stories are worse than others. For example, a young woman, classified as a hoarder, filled her apartment from floor to ceiling with objects and trash from the street. It was so extreme that when the front door was open there was absolutely no walkway, so the tenant created a tunnel. I was amazed that all the apartment contents did not come crashing down on us once we opened the door. Her accepting cat just stood on top of the mounds of clutter because the poor animal was unable to find an empty space on the floor.

After interviewing the client to assess her mental state, I was saddened to learn that she had been raped but never reported the incident. She ratio- nalized that if she barricaded the door, her rapist or other perpetrators could not get inside. Thankfully, the client was open to receiving assistance and was referred to an on-going therapy program. She also received extensive cleaning services and her place looked great. I’m glad we could help produce a happy ending for the client and her cat.

Not every hoarding story has a happy ending. One such involved a man who had towering piles of newspapers in every room, with a strate- gic placement of them so that his apartment resembled a fort. The client was secretive and would not offer any informational clues as to why he had chosen to live this way. He didn’t want therapy and needless to say, there was nothing I could do to help him.

All cases involve overcrowding but each has their own unique ele- ments. One 60-year-old woman’s apartment was so cluttered with new and never-used items, including picture frames and kitchen gadgets, that we were not clear what we were dealing with. Was she a shopaholic or a hoarder? Again, without a clear pathway to the door her apart- ment was considered to be a fire-hazard.

Another large home we visited housed a collection of old and new furniture and other items in every room. Even though the family pur- chased new objects, they still could not throw out anything that was old. For example, the kitchen had old and new jars; the bathrooms had old and new toothbrushes, and so on.

Some people mistakenly believe that if they are organized then they are not hoarders. When we enter homes and determine there is an excess of belongings we typically recommend a good general cleaning and get- ting rid of some items. In most cases, nothing gets discarded and the same items just get moved into a different room or into plastic bins. It is always difficult for hoarders to part with their belongings because they place more unconscious importance on them beyond their actual worth or usefulness.

When I began working in this field, I was surprised to learn that there is another type of hoarding—one which involves animals. A number of our agency’s employees worked with clients who housed from five to thirty animals at a time. Some of these pet owners are mentally ill, or in some cases misguided animal lovers who are unable to part with the strays they bring home. One extremely sad situation involved an elderly woman who was suffering from dementia. She had approximately 30 cats in her home and some were dead. A team of employees had to enter her apartment in Hazmat suits for protection against the hazardous odors and possible exposure to disease.

Hoarding not only affects the hoarders and their families. It can have a profound effect on the neighbors as well. Hoarding animals and/or trash from the street will inevitably create an odor that perme- ates throughout the interiors of buildings and even outside the home. Oftentimes there are also infiltrations of rodents and insects that run rampant throughout apartments.

The sad truth is that hoarding is so widespread that there are now specific agencies that provide cleaning and assistance for people with this problem. During client visits, look for signs of hoarding. They won’t be hard to spot. You might also check your own closets, cabi- nets and workspaces to make sure that everything you own is being used, or serves a useful purpose. If not—discard!

Background on Hoarding

Hoarding begins as an accumulation of items that has significant value in someone’s life. Hoarding may begin as “collecting” and when it gets out of control; the act of hoarding will impact a person’s daily life. It will impact that person’s ability to function in her/his home.

Hoarders mostly live in the past; they hold on to items that have sentimental meaning to them. Hoarders may also talk about the future as a reason to hold on to their belongings; they believe that “maybe one day I’ll need these items.”

Difference between collectors and hoarders:

Collectors:

  • Oftenfeelproudoftheirpossessions-theyliketoshow them off
  • Keep items organized, well-maintained and often displayed
  •  They find joy in items
  • They budget time and money for their collections

Hoarders:

  • Are embarrassed by possessions/are uncomfortable having others view possessions
  • Possessions are random and causes clutter
  • Often have extreme debt because they are purchasing items on sale etc… It’s a bargain so why not get 15 of the same items
  • Feel angry/violated when others talk about their possessions

Common Possessions:

  • Reading material/books/magazines/newspapers/pamphlets etc.
  • Clothes
  • Food/groceries
  • Photographs
  • Plastic bags
  • Jewelry
  • Household supplies
  • Tools/batteries

A few reasons why people save items:

  • Sentimental: has an attachment to items
  • Aesthetic: “This looks so nice. I will definitely use this someday.”
  • I need to keep this “just in case” I need it someday.
  • Indecisiveness
  • Fear of losing information (concerning old mail, magazines…)

How hoarding affects everyone involved:

Hoarders live in an unhealthy/unsanitary environment. Hoarders often develop:

  • Respiratory problems from breathing in the odor from gar- bage-being enclosed in a space that is not aired out. Those who already have respiratory issues often have their problem exacerbated by living in this condition.
  • May develop allergies or those already suffering from allergies will have that issue exacerbated-especially animal hoarders.
  • Headaches
  • Fatigue
  • Sleep problems: no bed to sleep on because the bed is covered with “stuff” or they cannot even find the bed. So much clutter that there is no space to sleep in the home.
  • Rodent/insect infestation
  • Pets urinate and defecate throughout the home because there are no litter boxes/wee-wee pads for cats or dogs and dogs are not walked.

Unsafe living environment:

  • An abundance of items in the home (clutter) usually block egresses (windows, staircases and doors). This is considered to be a fire hazard.
  • There are often times when hoarding can create a flammable situation: items surrounding a stove, heater, hotplate etc. A smoker utilizing lighters, matches, throwing away half-lit ciga- rettes.
  • The weight of all the possessions may cause structural damage to homes.

Virtually no functional living space:

  • Unable to utilize furniture (bed, couch, kitchen table, etc…) and appliances
  • Unable to utilize furniture (bed, couch, kitchen table, etc…) and appliances
  • Unable to utilize bathroom to shower and groom
  • No clean space to gather as a family and entertain friends
  • Financial constraints on the hoarder because s/he constantly orders food to eat and perhaps new clothes to wear.

Negative effects on socialization, the families and neighbors of hoarders:

  • Hoarders often live in isolation. They are embarrassed about their situation and do not invite anyone into their homes. They may either opt to always visit others or they do not socialize at all and remain home.
  • They may develop very poor hygiene which contributes to isolation. They often wear dirty clothes. If they cannot gain access to their bathrooms due to the astounding amount of clutter, then they are not able to take showers or brush their teeth. Sometimes they are not able to utilize the toilets and they urinate and defecate in buckets or plastic bags.
  • Families become fed up and do not want to visit the hoard- er’s home, resulting in very limited interaction among family members.
  • The strong odor emanating from the hoarder’s home and rodents/insects coming out of the door definitely affects the neighbors.
  • Garbage and other useless items are sometimes put in the front yards of hoarders’ homes; they do not care for and maintain their yards or the outside of their homes. This ulti- mately ruins the aesthetics of the neighborhood and lowers the property value of other homes.

Additional storage space for hoarders

For many hoarders, they do not believe that the apartment or house that they live in has sufficient space for their belongings and they actu- ally rent a storage unit. Renting a storage unit exacerbates the dilemma; this causes additional financial constraints and increased family drama.

I once had a client who was on a fixed income and was a hoarder. She had items piled up to the ceiling and had several cats. The hallway had a strong odor emanating from her apartment. Her tenancy was in jeopardy after the maintenance men discovered the severity of her cluttered apartment. She had a leak in her bathroom, which was affecting her downstairs neighbor. When maintenance attempted to enter her home in order to fix the leak, they were appalled to find how bad the hoarding situation had become.

The client had another agency assisting her and she promised to give away her cats and throw out all the unnecessary items. Unbeknown to everyone assisting her, she rented a storage unit and brought over her belongings from her apartment to the storage unit. Transferring her belongings from her apartment to the storage unit occurred for a couple of months before it was discovered. An employee from the Management Office saw the client pushing a carriage filled with her belongings and inquired about what he observed. The client could not pay her rent because she was paying for her storage unit. She placed herself in jeopardy of getting evicted due to non-payment of rent because she believed it was more important to keep her belongings and pay for a storage unit than it was to pay her monthly rent for her apartment. Fortunately for the client, the agency provided a heavy duty cleaning and assisted with paying her rent arrears. She eventually had to stop paying for the storage unit.

Helping the hoarder

More than likely someone who is a hoarder will not simply ask for help. Usually a hoarder may accept help/intervention if a family mem- ber strongly encourages that the situation changes. Family members may threaten to “cut all ties” to the hoarder. The hoarder may also be threatened with eviction; the thought of living on the streets and hav- ing her/his belongings being thrown out by strangers is scary!

It will be difficult for hoarders to throw out their belongings and possibly give away their pets (if they have an excessive amount); how- ever, it is possible to have the best outcome in this situation when it includes a group effort. Intervention, which includes support from fami- ly/friends and the help of professionals in the field, will more than likely yield a positive outcome. When the client is fully engaged in this process, it will also help in the reduction of an occurrence of relapse.

It will be important for family members and friends involved in this type of intervention to receive psycho-education concerning hoarders. The family members and friends should not only try to understand the reasons that their loved ones are hoarding, they should also learn how to relate and talk to the hoarder. “The in- tervention team” should develop skills as to how to relate with the hoarder and understand that they should not chastise or appear to be judgmental; they should also refrain from taking over the situa- tion by throwing everything out and not having a discussion with the hoarder first.

Cognitive behavioral therapy is the most effective form of treatment; however, this form of therapy can be very time-con- suming. It is an ideal form of treatment because it may be the most beneficial for the long run. This form of treatment will include cleaning the hoarder’s home one section of a room at a time. The professional will assist the hoarder with sorting out the posses- sions that are functional and necessary to keep. Certain items may be stored in bins after sorting through the hoarder’s possessions.

The hoarder will have to agree to donate and throw out certain items. The hoarder will have to learn how to shop in a productive manner. S/he will only be allowed perhaps two back-up items and not cases of the same items. S/he will have to commit to throwing out mail and other printed materials that are 3-6 months old. Other items such as plastic bags will also be limited.

Once the home is cleaned out, the client and the profession- al can work together to make the living space actually feel like a home. Attention to detail is important. The client should be en- couraged to have the home painted. Furniture should be bought and the home decorated nicely. The “new home” should not have any resemblance to the “old home.” The client and the profession- al should create a cleaning schedule and the client will have daily or weekly goals. Follow-up home visits from the professional and/or family members will help the hoarder to stay on track.

  • Unable to utilize bathroom to shower and groom
  • No clean space to gather as a family and entertain friends
  • Financial constraints on the hoarder because s/he constantly orders food to eat and perhaps new clothes to wear.

Negative effects on socialization, the families and neighbors of hoarders:

  • Hoarders often live in isolation. They are embarrassed about their situation and do not invite anyone into their homes. They may either opt to always visit others or they do not socialize at all and remain home.
  • They may develop very poor hygiene which contributes to isolation. They often wear dirty clothes. If they cannot gain access to their bathrooms due to the astounding amount of clutter, then they are not able to take showers or brush their teeth. Sometimes they are not able to utilize the toilets and they urinate and defecate in buckets or plastic bags.
  • Families become fed up and do not want to visit the hoard- er’s home, resulting in very limited interaction among family members.
  • The strong odor emanating from the hoarder’s home and rodents/insects coming out of the door definitely affects the neighbors.
  • Garbage and other useless items are sometimes put in the front yards of hoarders’ homes; they do not care for and maintain their yards or the outside of their homes. This ulti- mately ruins the aesthetics of the neighborhood and lowers the property value of other homes.

Additional storage space for hoarders

For many hoarders, they do not believe that the apartment or house that they live in has sufficient space for their belongings and they actu- ally rent a storage unit. Renting a storage unit exacerbates the dilemma; this causes additional financial constraints and increased family drama.

I once had a client who was on a fixed income and was a hoarder. She had items piled up to the ceiling and had several cats. The hallway had a strong odor emanating from her apartment. Her tenancy was in jeopardy after the maintenance men discovered the severity of her cluttered apartment. She had a leak in her bathroom, which was affecting her downstairs neighbor. When maintenance attempted to enter her home in order to fix the leak, they were appalled to find how bad the hoarding situation had become.

The client had another agency assisting her and she promised to give away her cats and throw out all the unnecessary items. Unbeknown to everyone assisting her, she rented a storage unit and brought over her belongings from her apartment to the storage unit. Transferring her belongings from her apartment to the storage unit occurred for a couple of months before it was discovered. An employee from the Management Office saw the client pushing a carriage filled with her belongings and inquired about what he observed. The client could not pay her rent because she was paying for her storage unit. She placed herself in jeopardy of getting evicted due to non-payment of rent because she believed it was more important to keep her belongings and pay for a storage unit than it was to pay her monthly rent for her apartment. Fortunately for the client, the agency provided a heavy duty cleaning and assisted with paying her rent arrears. She eventually had to stop paying for the storage unit.

Helping the hoarder

More than likely someone who is a hoarder will not simply ask for help. Usually a hoarder may accept help/intervention if a family mem- ber strongly encourages that the situation changes. Family members may threaten to “cut all ties” to the hoarder. The hoarder may also be threatened with eviction; the thought of living on the streets and hav- ing her/his belongings being thrown out by strangers is scary!

It will be difficult for hoarders to throw out their belongings and possibly give away their pets (if they have an excessive amount); how- ever, it is possible to have the best outcome in this situation when it includes a group effort. Intervention, which includes support from fami- ly/friends and the help of professionals in the field, will more than likely yield a positive outcome. When the client is fully engaged in this process, it will also help in the reduction of an occurrence of relapse.

It will be important for family members and friends involved in this type of intervention to receive psycho-education concerning hoarders. The family members and friends should not only try to understand the reasons that their loved ones are hoarding, they should also learn how to relate and talk to the hoarder. “The in- tervention team” should develop skills as to how to relate with the hoarder and understand that they should not chastise or appear to be judgmental; they should also refrain from taking over the situa- tion by throwing everything out and not having a discussion with the hoarder first.

Cognitive behavioral therapy is the most effective form of treatment; however, this form of therapy can be very time-con- suming. It is an ideal form of treatment because it may be the most beneficial for the long run. This form of treatment will include cleaning the hoarder’s home one section of a room at a time. The professional will assist the hoarder with sorting out the possessions that are functional and necessary to keep. Certain items may be stored in bins after sorting through the hoarder’s possessions.

The hoarder will have to agree to donate and throw out certain items. The hoarder will have to learn how to shop in a productive manner. S/he will only be allowed perhaps two back-up items and not cases of the same items. S/he will have to commit to throwing out mail and other printed materials that are 3-6 months old. Other items such as plastic bags will also be limited.

Once the home is cleaned out, the client and the profession- al can work together to make the living space actually feel like a home. Attention to detail is important. The client should be encouraged to have the home painted. Furniture should be bought and the home decorated nicely. The “new home” should not have any resemblance to the “old home.” The client and the professional should create a cleaning schedule and the client will have daily or weekly goals. Follow-up home visits from the professional and/or family members will help the hoarder to stay on track.