A little more than a week ago our local chapter of NAPO had a local mental health counselor come and speak with our members about helping clients with hoarding habits. Clients with Hoarding Habits are not my typical clientele…but there are several circumstances that I knew the client was on a deadline and the family was in a tight spot. Under the right circumstances I’ve helped quite a few clients with hoarding habits.

Hoarding was first discovered and labeled as such in 1947 in NYC when two brothers were found diseased under a pile of stuff in their home. Today it is estimated that over 3 million people suffer from “hoarding” and many go without treatment or diagnosis. This is not a disorder people are born with.

This project began with an intervention…this was the first time I was asked to be a part of an intervention. I had not yet met the client and was not involved in the decision to begin this way. The family took the approach they felt was best and there was a lot at stake and not much time to act. This client was a senior living in a senior facility…they knew she was a bit of a “pack rat” but the problem had escalated to put her health and safety in jeopardy. This is not unusual for clients with hoarding habits, especially senniors and I’ve since worked with several other seniors under extreme health and safety circumstances, I felt compelled to help with the support of the family. Each circumstance is different and I believe that though family, friends and professional organizers can help to a certain extent, mental health professionals are the most important tool for helping clients with hoarding habits.

Common circumstances or signs of (seniors or others) hoarding habits include:

• Hazardous or risky living conditions including loss of power, running water, old/expired/moldy food, human or animal waste or bug infestations.
• A tenancy to dis-associate with the problem, including assigning blame to others, making excuses for their behavior or justifying their behavior as “normal”.
• “Save it” mentality (but not necessarily the critical thinking to know what’s valuable and what’s not).
• Denial of any problem or in-ability identify problems.
• Anger or agressiveness towards people who attempt to help them get rid of items they do not need.
• Obsessive or compulsive tenancies (there are some different opinions regarding hoarding and OCD).
• Depression or anxiety (this can be another sign but isn’t in and of itself a trigger)
• Poor coping skills and lack of emotional regulation.
• Excessive collecting of a variety of items that there is no rhyme or reason to (dolls, bottles, foil, containers, other collectibles etc)…not all collecting is hoarding!

I’m not a psychiatrist or counselor and I do not make a diagnosis of a hoarding disorder, but I can still understand behavior patterns that are warning signs that can lead to hoarding. Most importantly, I can be there to help support my clients in the process of learning to make healthy choices, recognizing their repeated behavior patterns and seeking the help of their family (if they are willing), mental health professionals and others who can support them as they try to heal and unpack their behavior.

Both this and other clients I’ve worked with had no choice once confronted with the family and director of the facility. It’s not uncommon when hoarding habits get severe that these individuals or families facing losing their home if they don’t get help.  This is never an ideal situation and I wish for their sake it had not come to this.

When I work with clients with hoarding habits I am compassionate while maintaining healthy boundaries and am clear that “clutter” can not be allowed back into the home. Maintaining this is something that should be done with the help of mental health professional who will know the triggers and signs of relapse.

With this project, the client was getting a total apartment renovation with new floors, new paint, appliances and some new furniture.  We (the family and I) remain positive and tried to make the experience as stress free as possible while keeping physical and mental challenges in mind. Working with seniors requires awareness of health conditions and they may tire more easily and have significant physical limitations.  Below are photo’s of before, during and after of this small studio apartment.

Above is the main living area before we began.  The center and perimeters of the room were stacked with furnishings and boxes (of mostly papers and junk).  There were furnishings obstructing the main pathway and the closet was inaccessible.  Her newly renovated apartment has open floors, much less furniture and is clean and freshly painted.

Bathroom and entry hallway.  In the before photo’s you can see that the path was obstructed with furniture and clutter.  This is a safety (trip) and fire hazard and one of the key things to look for in determining if someone has hoarding tenancies.  The bathroom was almost completely unusable with boxes and clothing piled up in the shower and on top of the toilet.  I’m not sure how this woman used her own facilities, perhaps she didn’t and used the public restroom but this is not a healthy or safe environment for anyone, much less a senior.

Finally the pictures above show the main living area looking into the kitchen.  The floors had various rugs that were big trip hazards and the clutter was obstructing half of the kitchen.  The bottom left photo shows a small portion of the trash that we hauled out on day two and the bottom right shows the clean and renovated kitchen with new appliances.

This project was finished in three days and I did some of the work on my own but also had the help of the family.  It was important for me to establish trust with the client before the family worked with us. By them getting involved with the project hands on, they were able to better understand where they may need to monitor and help maintain hoarding habits in the future.

The follow through on their part will be critical in helping this client maintain this new, healthier environment.  As is usually the case, the client was not overly thrilled with having to let go of many of her belongings but in the end we kept everything she was most attached to (of both practical and sentimental value).

If you suspect that a family member is living in unhealthy hoarding conditions consider speaking with a professional (psychiatrist, psychologist or counselor with hoarding experience) before taking steps to intervene.  Much of the time can be relapse, which can be frustrating for everyone but in some cases the immediate health and safety needs have to come first.

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