How To Help A Hoarder - Important Do's And Don'ts

By: Michael Puskar

Updated December 22, 2020

Medically Reviewed By: Elizabeth Strong

Living with a loved one who is a hoarder can be extremely stressful. It probably affects your ability to be as close to that person as you would like. Maybe you avoid visiting your friend or family member in their home. Perhaps you have difficulty spending time together because the hoarding issue takes up space, like an elephant in a very cluttered room.

You probably want to help your loved one. Maybe you've tried a few things, but nothing seems to help. This article aims to help you understand hoarding, its symptoms, causes, and things to do and maybe just as importantly, things not to do to help your loved one on the road to recovery.

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According to the American Psychiatric Association, hoarding affects anywhere from 2 to 6 percent of the population. The cause of hoarding disorder is currently unknown, but that does not mean that there are not any effective treatments available that can help provide relief. CBT, or Cognitive Behavioral Therapy, is one of these treatments that are widely available. CBT has worked for countless patients by changing their thoughts towards their possessions. Using CBT, they will gradually become less distressed about holding onto possessions and will have a decreased desire to keep future ones. By reducing the effect that these items have on the person, CBT and other treatments can help people recover from hoarding disorder.

What Exactly is Hoarding Disorder?

According to the Mayo Clinic, "Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. A person with hoarding disorder experiences distresses at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs." This serious mental health disorder can lead to dangerous living conditions, malnutrition, and poor personal hygiene. While the cause of hoarding is unknown, experts agree it is important for a hoarder to seek professional help as soon as possible after symptoms are identified.

Symptoms

Symptoms of hoarding range from mild to severe. In general, hoarders accumulate and save large volumes of possessions, regardless of their value. Hoarders experience extreme attachment to inanimate objects and severe anxiety when making decisions. These items pile up to the point that they create difficulty using the space for its intended purpose. Occasionally, some of these symptoms can be explained by other disorders such as decreased energy to clean caused by depression or symptoms of obsessive-compulsive disorder. However, hoarders display a unique combination of symptoms:

  • Acquiring and saving items regardless of their value.
  • Extreme distress at the idea of getting rid of possessions.
  • Accumulating possessions to the point that it makes rooms unusable. For example - Stacks of newspapers on seating and dining areas, piles of clothes on the bed, heaps of possessions causing narrow pathways from room to room.
  • Poor organization, losing important items or documents in the clutter.
  • Conflict with those who try to remove items from home.

As hoarding symptoms increase, the person may experience isolation from others and health issues related to compromised living conditions.

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How do I know if my loved one have hoarding disorder?

If your loved one experiences a combination of the symptoms listed above, it is important to encourage the person to seek professional help. The earlier the person seeks help, the more successful the treatment tends to be. Perhaps you see the clutter in your loved one's home as hoarding, but the person only thinks it is messy. If this is the case, it can be useful to use this Clutter Image Rating guide from the Obsessive Compulsive Disorder Hoarding Center. If rooms closely match image 4 or above, it is very likely your loved one is a hoarder.

Hoarding is different from collecting. Both activities involve acquiring items to which a person gives a special value that may go beyond the item's actual worth. Collectors tend to organize and display items carefully. Collectors are usually proud of their items and like to talk about them or show them off. Hoarders, on the other hand, are often embarrassed about the status of their living situation. They also may avoid inviting people into their homes.

Though they are different, collecting can become hoarding. When a collection begins to move beyond its designated containers and impede on a person's living space, that collector may be becoming a hoarder. If you start seeing these traits developing in a friend or loved one, it may be time for that person to seek professional advice and treatment.

Causes

You may wonder why hoarders keep so many possessions when it seems so obvious that the behavior is unhealthy. Very little is known in the psychology community about what causes a person to begin to hoard. Experts say hoarding tendencies often begin as young as puberty, but most people who seek professional treatment for the disorder do not do so until they are 50 or older.

Some believe hoarding tendencies are related to inherited brain patterns and are related to anxiety or obsessive-compulsive disorder. For some, hoarding begins following a significant traumatic experience.

People who hoard say they acquire and keep items for a variety of reasons:

  • They believe an item will be useful or valuable in the future.
  • They feel it has sentimental value, is unique, or irreplaceable.
  • They feel it is too good of a bargain to pass up or throw away.
  • They think items will help them remember an important person or event they might otherwise forget.

How to help a hoarder - "Don'ts"

Hoarders experience extreme distress at the idea of getting rid of their possessions. It may be tempting to simply clean up for the hoarder. However, like many psychological disorders, forcing someone to change is often not effective and may even backfire and make the problem worse.

  • Don't remove things from the hoarder's home without consent. It may seem like if they could just start with a clean slate, the person would be much better off, but getting rid of clutter does not address the extreme emotional distress caused by the idea of losing valuable or important items. Throwing things away or getting rid of them without permission is not successful in the long-term. The hoarder is likely to revert right back to old behaviors. On top of that, the hoarder may become very upset with you. This can diminish the chances of them seeking professional help.
  • Don't expect the cleaning process or the healing process to happen overnight. It takes a long time for a hoarder to get to the point of having a house that is unsafe, and it can take a long time to change both the environment and the behaviors that caused it.
  • Don't enable their behavior. While taking items against a person's will is not helpful, adding to their clutter by buying or giving them things or taking them on shopping trips is just as bad. Avoid adding to the clutter by showing your love in other ways and spending time doing activities not related to consumption.
  • Don't clean up after them. Just like removing things without permission, cleaning up after a hoarder could keep them from addressing the deeper issues that are leading to the hoarding in the first place.
  • Don't expect perfection. Just like with dieting, spending money, gambling or drinking, a hoarder is likely to experience setbacks even after receiving professional treatment. See these for what they are normal human imperfection and keep showing love and support.

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How to help a hoarder - "Do's"

Now you know what not to do if you have a loved one who hoards, but you may be wondering if there is anything you can do to help them. While the disorder that leads to hoarding will likely be something your loved one must face for the rest of their life, the good news is, there are steps you can take to help a hoarder reclaim their space and their lives.

  • Do encourage the person to seek professional help. You cannot force a person to get help against their will, but you can encourage someone by helping them find a therapist and resources in their community to help them get the help they need.
  • Do take the time to learn about hoarding. While TV shows about hoarding may spread awareness about the disorder, many experts say these shows paint an incorrect picture about hoarding and how to help a person who hoards. Look for credible sources like the Mayo Clinic, National Alliance on Mental Illness, and the American Depression and Anxiety Association of America.
  • Do help them with their belongings if they ask for help. During or after receiving professional treatment, a hoarder may seek your assistance in dealing with the accumulation of clutter in their home, car, and other spaces. Help when you can or consider seeking professional movers and cleaners if the task becomes too daunting.
  • Do listen to your loved one. Try not to judge them for their hoarding any more than you would judge someone for having a physical health ailment like diabetes or asthma. Hoarding is a mental disorder. It is not something a person simply chooses to do. Your support and openness will go much further toward encouraging your loved one to seek professional treatment than your judgment or disappointment.
  • Do recognize the positive change. Hoarding doesn't happen overnight, and it won't be solved overnight. Encourage and praise your loved one if you see them attempting to clean or organize a small space or making the decision to talk to a professional. Your love and support will be instrumental in helping a hoarder get on track and stay there.

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Online therapy can be a convenient, stress-free, yet effective way to start addressing hoarding behaviors, and at BetterHelp, licensed counselors and therapists who are trained to modify behaviors and use techniques such as CBT are available to help people who struggle with hoarding to overcome their thoughts, feelings, and anxiety, about separating from their belongings.

Adapting to life without hoarding will take time, and will be challenging, but by giving people the skills they need to cope, people can live a life free of hoarding. Additionally, maintenance and regular check-ups may also be required to make sure that the individual does not relapse back into old habits. Read below for some reviews of BetterHelp counselors, from people experiencing similar issues.

Counselor Reviews

"I find that Dr. Morritt goes to great lengths to make our interactions very comfortable in a way that I feel safe sharing myself with her. I am not worried about being judged, and I appreciate the times when she empathizes or relates to parts of my life. Dr. Morritt is thoughtful in her responses in a way that allows me to let go, grow, and see other points of view."

"I began working with Courtney during a time when I was very anxious, overwhelmed, stressed, and needing someone to help me work through the chaos in my mind. Courtney was so empathetic, understanding, and non-judgmental, and encouraged me to let go of things that were no longer serving me. Courtney always checked in to see how I was doing if I hadn't been messaging her and that meant a lot to me. I felt respected, heard, and validated. I would recommend her to anyone."

Conclusion

As many as one in 50 Americans suffer from hoarding disorder, but treatment is available to 100 percent of those who have it. When one considers their friends and loved ones, the effects of hoarding are much more widespread. There is no perfect solution to helping a loved one who hoards, but patience, love, and understanding are key and encouraging your loved one to seek professional help is probably the most effective step you can take, and by following the advice in this article, you can make it that much easier.

Frequently Asked Questions (FAQs)

How do you get a hoarder to stop hoarding?

Here are some steps to help a hoarder stop hoarding:

  1. Step Back and Examine Your (and your Family’s) Behavior

A first step is to consider things you or another family member might be doing that may contribute to the love one’s hoarding problem. For example, a sister might save newspapers and give them to her brother who suffers from hoarding, or a mother might pay the monthly bill for a storage unit to allow her daughter to store bottles and magazines. “Helping” yourloved one by doing these things is referred to as family accommodation. Usually relatives accommodate because they think it helps or because it avoids arguments. Yet, in reality, accommodation reinforces hoarding behavior, allowing it to become more of a problem in the long run.

  1. Improve your Family Communication

In addition to decreasing family accommodation, family members can also benefit from working to improve communication. Discussing the hoarding problem and ideas for problem solving in an open and accepting way is an important first step. Respecting the loved one with hoarding behaviors’ attachments to possessions is critical to being able to hold such discussions. This can help to establish respect for the rights of each member of the household as well. An atmosphere of understanding can help with negotiations to keep certain spaces clutter-free which will help maintain family harmony.

It is important to remember that the path to change is not always a straight line. A loved one may be motivated one minute and ambivalent about changing behavior the next. There might even be periods of getting worse during the process. Don’t force the issue. This pattern is normal. The overall improvement, more than the day-to-day changes, should be the goal.

  1. Change your Expectations

Sometimes it is important for family members to change their expectations about a loved one’s hoarding behaviors. It is common for family members to tell a loved one with hoarding to stop saving stuff because “hoarding is wrong,” “homes should be clean and organized,” or something similar. Expecting a loved one to show complete organization and cleanliness is simply not realistic – at least not at first. It might help family members to instead set goals and expectations that focus on reducing the harmful consequences of the hoarding – a strategy known as harm reduction – rather than just stopping the hoarding.

Tension in the family can decrease when harm reduction becomes the focus of change rather than getting rid of things. Involving the loved one with in the harm reduction plan can make the process friendlier, which enhances their motivation for change.Often harm reduction gets a loved one started in the change process, and sometimes this energy leads to better decisions about what to acquire and save. But sometimes it doesn’t, and although the home is safer, it may still be cluttered. Harm reduction focuses on reducing danger and increasing safety without focusing on getting rid of clutter.

How do you cure a hoarder?

Treatment of hoarding disorder can be challenging because many people don't recognize the negative impact of hoarding on their lives or don't believe they need treatment. This is especially true if the possessions or animals offer comfort. If these possessions or animals are taken away, people will often react with frustration and anger and quickly collect more to help fulfill emotional needs. However, there are many great program resources available to assist with hoarding. It’s advised that health professionals be consulted to decide on the best treatment plan, including the type of therapy and medications, if needed.It’s important to find a therapist or other mental health professional with experience in treating hoarding disorder to help you find treatment.

The main treatment for hoarding disorder is cognitive behavioral therapy. Medications may be added, particularly if you also have anxiety or depression.

  • Psychotherapy – Psychotherapy, also called talk therapy, is the primary treatment. Cognitive behavioral therapy is the most common form of psychotherapy used to treat hoarding disorder.

The cognitive behavioral therapy may include:

  • Learning to identify and challenge thoughts and beliefs related to acquiring and saving items
  • Learning to resist the urge to acquire more items
  • Learning to organize and categorize possessions to help you decide which ones to discard
  • Improving your decision-making and coping skills
  • Decluttering your home during in-home visits by a therapist or professional organizer
  • Learning to reduce isolation and increase social involvement with more meaningful activities
  • Learning ways to enhance motivation for change
  • Attending family or therapists support groups
  • Having periodic visits or ongoing treatment to help you keep up healthy habits
  • Treatment often involves routine assistance from family, friends and agencies to help remove clutter. This is particularly the case for the elderly or those struggling with medical conditions that may make it difficult to maintain effort and motivation.

Is hoarding a mental illness?

Hoarding is a mental health condition and disorder that may be present on its own or as a symptom of another disorder. Those most often associated with hoarding are obsessive-compulsive personality disorder (OCPD), obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and depression; however, only 2% - 5% of people have this diagnosis.Research has indicated that hoarding, a relatively common disorder among the older people, gets progressively worse as a person gets older. It’s important to find a doctor or therapist who specializes on mental health disorders such as hoarding to determine if the symptoms are psychological or medical in nature. Most mental health facilities have a resource directory for therapistswho can assist you find the right therapist.

What are the 5 levels of hoarding?

Hoarding Level 1

The first level of hoarding is the least severe. The residence of a level 1 hoarder may include:

  • Light amounts of clutter and no noticeable odors
  • All doors and stairways are accessible
  • No more than three areas with animal waste throughout the house
  • Hoarding level 1 involves few signs that an individual has a hoarding disorder. The lack of clutter might hide the condition, but the individual may still have difficulty throwing away items and shop excessively for objects they do not need

Hoarding Level 2

Hoarding level 2 requires a blocked exit from a person’s residence, one appliance not working for at least six months or the presence of a malfunctioning heating, cooling or ventilation system for at least six months. This level of hoarding involves additional clutter around the residence, specifically in two or more rooms, and narrow pathways through the home. There must also be at least a light amount of mildew in one bathroom or the kitchen. Negative health conditions are beginning to appear. Other characteristics include:

  • Light pet odor
  • Pet waste on the floor
  • At least three incidents of feces in a litter box
  • Minimal fish, bird or reptile care
  • Evidence of household rodents
  • Overflowing garbage cans
  • Dirty food preparation surfaces
  • People within hoarding level 2 may avoid inviting people into their homes or show embarrassment due to the state of their residence. This level of hoarding may cause anxiety or a depressed state and lead to withdrawal from social interaction

Hoarding Level 3

Residences within hoarding level 3 have visible clutter outside of the home, including items that are usually indoors (such as televisions and furniture). At least two appliances have been broken for six months, and one area of the house has light structural damage. The number of pets exceeds regulations, and animal tanks and cages are neglected. There is visible and audible rodent evidence, fleas, spider webs and narrow paths through the halls and stairways. Other characteristics include:

  • At least one unusable bathroom or bedroom
  • Small amounts of hazardous substances or spills on the floors or surfaces
  • Excessive dust
  • Dirty clothes, towels and sheets
  • Blocked electrical outlets resulting in tangled cords
  • Overflowing garbage cans
  • Odors throughout the house
  • A person within this level often has poor personal hygiene and weight issues due to an unhealthy diet. An individual in this level of hoarding may become dismissive or angry when approached by friends or family members about the state of their lifestyle

Hoarding Level 4

Residences within hoarding level 4 have noticeable mold and mildew throughout the building, structural damage that is at least six months old, odors and sewage buildup. The number of pets exceeds regulations by at least four, and there are more than three visible areas with aging animal waste. The bedroom is unusable and rotting food is on surfaces. Other characteristics include:

  • Aged canned goods
  • No clean dishes or utensils
  • Beds with lice, or other bugs, and no sheets or covers
  • Excessive webs and spiders
  • Bats and other rodents audibly noticeable in the attic and walls
  • More than one blocked exit
  • Flammable substances stored in the living room
  • People within hoarding level 4 have poor hygiene and may not bathe for weeks. These individuals often have worsening mental health and focus their emotional energy on grandiose plans or nostalgic memories

Hoarding Level 5

Hoarding level 5, the most severe type of hoarding disorder, involves severe structural damage to the residence. Broken walls, no electricity or running water, fire hazards, and visible rodents and other non-pet animals are a few of the characteristics of homes within hoarding level 5. The health and safety of those living in the residence is in dire condition. Other signs include:

  • Clutter filling bathrooms and kitchen
  • At least four too many pets, per local regulations
  • Noticeable human feces
  • Rotting food on surfaces and inside a non-working refrigerator
  • People within hoarding level 5 often do not live at their residence due to the clutter but rather stay at a friend’s or family member’s house. They may also discharge their waste into bottles or buckets that remain inside the home. Individuals within this level of hoarding usually have noticeable symptoms of depression

Are hoarders just lazy?

Contrary to what you might think, people experiencing compulsive hoarding are not just being lazy or careless. And it’s not that they can’t find time to clean. They are experiencing an anxiety-related condition; although, there is disagreement in the medical/psychiatric community as to whether hoarding is its own issue, or that compulsive hoarding is a subtype of obsessive-compulsive disorder (OCD). Although many people experiencing OCD also exhibit hoarding behavior, not all people experiencing OCD also hoard, and many people who hoard have no other symptoms of OCD.

Is a messy house a sign of mental illness?

A messy house could be a sign of a mental illness such as hoarding. However, a messy house could also be indicative of other issues. Here are some possible ones:

A messy room can also be a sign that you have depression

Several of the criteria for a depression diagnosis – hopelessness, fatigue, and lack of concentration –can all play a role in why your messy room is in the state it's in. If you can barely get out of the bed due to your depressive state, it's unlikely that you’ll have the energy to clean your room. Furthermore, if you're feeling a little less than hopeful, you might have a hard time understanding why you should even bother to clean up or organize things since, from your point of view, everything seems to be going wrong anyway.

Lack of concentration. Lack of concentration, one of the symptoms of depression, can also can make the actual task of cleaning up your room almost impossible. Even if depression isn’t the cause of the forgetfulness, if you're overwhelmed or have a lot going on in your head, cleaning your room can still be a major challenge.

What is the difference between clutter and hoarding?

Hoarding is collecting huge amounts of things, often items of little value (e.g., ketchup packets, newspapers). A hoarder finds it excruciatingly painful to let go of things, so they end up not letting those things go.As a result, stuff piles up in ways that are unsafe, they are oftentimes unable to find items, they don’t clean mainly because there is overwhelmingly too much to clean or it’s too hard to clean, and they find themselves affectingtheir personal and professional relationships.

On the other hand, Clutteris basically a place with a fair amount of mess; but, unlike hoarding, the home is safe to move around in. They can straighten up enough to feel at ease having guests over to entertain. In addition, rooms are used the way they're meant to (i.e., no paper piles in the bathtub with hoarding).

Some people collect lots of things, but unlike a hoarder's stuff, these items that are cluttering up the home have value or personal meaning. People with a problem with clutter, however, may have trouble getting rid of the clutter and keeping their home tidy. They might find that they can’t decide which valuable item can stay and which one can’t. They might find it hard to clean and keeping the place clean, even if they get help with cleaning or organizing. Even though it may be clean for a short while, the clutter usually returns.


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