Hoarding is considered collecting to the extreme. When the items collected interfere with normal daily functioning, lead to an unsafe living environment, or are considered a public hazard, it is hoarding. The most common cause of this syndrome is obsessive-compulsive disorder. The person’s obsessive thoughts lead to the compulsive purchasing or collecting of items. It is a very difficult behavior to change; though, if the person is willing, they can learn to change their thought processes, which normally will change the behavior.
Another common cause is severe trauma or loss in childhood. The items comfort the hoarder and/or help them feel safe. When moving a hoarder, it is difficult to find a safety replacement if the items are removed, so it is often better for the hoarder to take many of the items with them when they move.
There are numerous other causes of hoarding: severe depression, dementia, attention-deficit disorder, and the manic phase of bipolar disorder, to name a few. The common traits of most hoarders include limited insight into the problem and the inability to resist collecting. It is very hard to stop the behavior without assistance from others. Most hoarders are very anxious about discarding even a single item. Many don’t ask for help in cleaning up because they may have an emotional attachment to the items, even items others may identify as trash. Hoarders rarely clean up their environments unless forced to do so by others.
Many of us don’t understand or accept the trauma to a hoarder when cleanup is required. The following is a quote by an 85-year-old man who was forced to clean up in order to avoid eviction: “The emptiness is a little hard to get used to. For one thing, the traffic noise is very loud now. And I feel hollow. I put so much work into saving – years and years – and it’s suddenly gone. It’s like somebody had died, or a fire or an earthquake had happened. It’s like the change from hot to cold.
Because helping a hoarder to move is so difficult, it is necessary to have great patience and empathy in order to help. The hoarder often has to touch each item and make a decision about each item. It is often better if the coach/support person is not a family member who has gotten frustrated with the hoarding. The coach needs to constantly keep the hoarder on task and remind them to relax by breathing deeply with them.
The goals need to be kept small. Sometimes only cleaning an hour per day is all the hoarder can manage. Have boxes or bags labeled: keep, recycle, or donate. Very little will be thrown away. It is important to acknowledge that the items are of value to someone else. This allows the hoarder to let go more readily. Constantly remind the hoarder why the cleanup is necessary and what the benefits are to them of the upcoming move.
If there is limited time to clean out the house, it may necessitate putting pressure on the hoarder. Often the only way to accomplish a quick cleanup is without the hoarder present. It is rare that I would recommend this, but the need to sell the home may necessitate this. Another way to manage a quick move or home sale is to agree to move everything into a storage unit, allowing the hoarder to go through everything in the future at their leisure. This can be an expensive but effective way to deal with the sale of the house.
In summary, it will always be difficult to help a hoarder clean up their home because of their attachment to every item in the home. It is important to work respectfully with the person, and honor their wishes as much as you can. If there is a time constraint and the cleanup must be accomplished quickly, take the time to explain as you go. Share with them why it is not possible to give them the time they feel they need, and negotiate with them what items can be moved or stored.
By Karen Kent, Creative Geriatric Services, firstname.lastname@example.org. Karen has 35 years of experience in the geriatric mental health field and is currently in private practice working with elders, hoarders, and families. She has great empathy for all involved in the cleanup process.