Helping a hoarder is a delicate process that has less to do with the hoarder's stuff—no matter how much stuff there is—and more to do with recognizing the hoarder's unique challenges with care and compassion.
Hoarders are people who have accumulated so many possessions that they often cannot function effectively in their homes. They typically are unable to find things they need, to use furniture for its intended purpose, or even to prepare and eat a meal. "A hallmark problem is difficulty discarding," says Gail Steketee, Ph.D., dean and professor at the Boston University School of Social Work. Hoarding is often linked to mental health disorders, including major depression, social anxiety, general worry, and obsessive-compulsive disorder. About 4% of the population struggles with hoarding, according to Steketee.
Randi Lyman, owner of A Helping Hand—Professional Organizing Service, Austin, Texas, often gets calls from hoarders or their family members seeking help. She notes that hoarders may suffer from:
Lyman has worked with hoarding clients in conditions ranging from the narrowest of walkways through the clutter, known as "goat paths," to extreme filth. Their accumulated possessions can result from compulsively overspending on unneeded items, inheriting family members' possessions, dumpster diving, or free giveaways.
Hoarders' finances often suffer from their disorder. Three out of four hoarders shop too much, which can lead to high credit card balances, according to the OCD Foundation, Boston.
Inability to manage paper, which may be buried under mounds of muddled possessions, can lead to unpaid bills. Overwhelming clutter may lead to citations for health and safety risks, trigger the condemnation of the home, and make it impossible to obtain homeowners insurance. Landlords may attempt to evict hoarders.
"People who hoard have lower incomes than people without hoarding," Steketee says. "Loss of housing may be a major contributor, and damage to the value of the home because repairs have not been made is another one. Items lost in the clutter are replaced by purchases that cost money."
Lyman says hoarders often lack insight into the impact of their behavior, which may force other family members to live in unhealthy, unsafe conditions.
When family members attempt to declutter, hoarders are likely to fiercely resist, leading to anger and mistrust. The family lives with "doorbell terror"—the fear that someone will see the inside of the residence.
Support groups such as Children of Hoarders can help families cope with these issues. Families also can seek help from mental health professionals who specialize in helping hoarders and their families.
Steketee recommends that family members read "Digging Out: Helping Your Loved One Manage Clutter, Hoarding, and Compulsive Acquiring" by Michael Tompkins and Tamara Hartl, which addresses the motivations for hoarding and the complexity of trying to resolve the problem.
"Then, they should focus on the immediate, real dangers and work on those rather than becoming embroiled in a tug-of-war about what to keep and what to get rid of," Steketee says. "External assistance from human service providers may be needed to move this forward."
Television programs that focus on "makeovers" of hoarders' homes strive to achieve an overnight transformation. Lyman and Steketee say the answer is rarely that simple.
"There are no easy fixes," Lyman says.
Help for hoarders usually starts with mental health treatment that helps them learn to let go of possessions and make decisions about what to keep and what to throw out.
Once the hoarder expresses a desire for assistance, you can hire a professional organizer or cleaning company to speed up the clean-up and create systems to manage paperwork and possessions. Lyman, a certified professional organizer specializing in chronic disorganization, emphasizes that organizers who work with hoarders should receive specialized training.
Lyman says it's essential to show respect for hoarders' needs and preferences when offering help. She never touches anything in a hoarder's home without his or her permission.
"Do not plan a clearing-out intervention in a hoarder's home by throwing out their belongings with or without their knowledge," Lyman says. That approach will create mistrust and hurt feelings and may even cause the hoarder to attempt suicide or suffer additional mental health problems.
Multiple appointments and periodic follow-up visits are needed to maintain improvements.
Family members may be able to help hoarders with some financial tasks. When hoarders are willing to accept help in dealing with finances, Lyman suggests enrolling them in automatic payment services offered by utilities and online banking programs, including online bill payment.
Automating these tasks helps ensure that essential bills are paid. Reducing the volume of incoming mail is important.
"Opt out of as much stuff as possible," Lyman says. "Stop the blizzard of paper from coming into the house so they don't have to deal with it."
Friends and family also can offer emotional support and provide information about community resources. Persistence is likely to be required, along with ongoing reassurance for the hoarder.
"By the time the problem is discovered, it has usually persisted for decades, making it not a simple matter of throwing things out," Steketee says. "Effective relief from hoarding takes time and sustained effort to accomplish."
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