IntroductionThe trim-looking Orangevale home has a secret. Inside are towering piles of stuff that fill the rooms, line every hallway and block doorways. Leaning against the walls are unopened portable grills, rolls of Christmas gift wrap, and empty boxes and bags.
The only place for a visitor to sit is on a folding chair that the 83-year-old homeowner places 4 feet inside the home’s entryway. She stands chatting with her elbow resting on a nearby pile.
“What you see is in every room,” explained the woman, who has been counseled by Sacramento County Adult Protective Services about the health dangers of her jampacked home. “It’s just stuff I didn’t want to throw away.”
The woman asked not to be identified because of her embarrassment over her situation. But the condition is a serious problem that frustrates social workers, building inspectors, landlords and, most of all, worried relatives.
Older people can fall in the mess or be killed in clutter-caused fires. They can lose their homes because the junk keeps them from properly maintaining the property.
Compulsive HoardingAn estimated 600,000 to 1.2 million people suffer from compulsive hoarding syndrome, a difficult-to-treat condition that is attracting more research and intervention.
Later this month, more than 100 professionals will participate in a special presentation by Sacramento County Adult Protective Services.
While compulsive hoarding is not unique to seniors, they often get identified because of age-related concerns such as falls that can threaten their independence.
“It’s not a character flaw. It’s not laziness,” said Karron Maidment, a research associate with the Obsessive Compulsive Disorder research program at UCLA, who will teach the Sacramento seminar. “They’re trying so hard to do things perfectly and getting so overwhelmed that they put everything off. If they can’t do it right, they’re not going to do it at all.”
The difference between ordinary clutter and hoarding is based on criteria established by mental health professionals.
Hoarders accumulate stuff that others regard as useless to such a degree that living spaces can’t be used for their original purposes, causing distress or impairing the hoarders’ well-being.
They save everything, because it could be needed later or could be useful to someone else. Throwing away anything creates anxiety.
Building inspectors have found people living on porches or in cars because there was no room to sleep in their homes. Hoarders may not get needed repairs for the stove or toilet, because they don’t want to let anyone inside the house.
A Hidden BehaviorRandy Frost, one of the foremost researchers on hoarding and a psychology professor at Massachusetts’ Smith College, believes the number of people afflicted is underestimated because it’s a hidden behavior.
Frost said: “I find it absolutely amazing the number of people who are coming out of the woodwork when people hear about the research I do. ‘I have an uncle, a friend or a neighbor.’ ”
Many are comforted just to learn they are not alone and that the problem has a name, he said. Some of the most commonly hoarded materials are newspapers, mail, clothes and containers.
Frost compared how hoarders feel about discarding stuff to how anyone else would feel about throwing away their much-needed driver’s license.
“They have the same kind of view of virtually everything,” he said. “There’s something about the act of acquiring it, the sense of having it even though it’s never used or opened, that is powerful.”
Families often think they can help by cleaning up. But without the help of a mental health counselor, Frost cautioned the hoarder no longer will trust relatives and the home will be filled again.
“We see lots and lots of fractured families over this,” said Frost. One of the more successful approaches he’s used is to provide hoarders with factual information, because they are often curious about their own behavior.
Maidment works with them on their decision-making skills during a six-week intensive program at UCLA. One box of stuff at a time, she goes over one item at a time to help them learn how to make the decisions about what to discard or keep.
“We encourage them to take a risk and throw it away and tolerate the anxiety it causes,” said Maidment. “It’s practice making decisions. It’s very, very time consuming.”
Professional Help Is CrucialDr. Paul Munford, a professor of psychiatry at UC Davis School of Medicine and a clinical psychologist with the Anxiety Treatment Center of Northern California, said professional help is crucial.
“It takes active involvement on the part of the therapist, which would include going to the home, surveying the situation and trying to help the person come up with a plan,” said Munford.
Some cases surface when city or county building inspectors decide a home is unsafe. They can then order a cleanup and bill the homeowner for the costs.
The 83-year-old woman in the Orangevale home has been counseled about the dangers of having so much stuff in her house by Judy Kietzman, a social worker with Adult Protective Services.
Kietzman said she’s talked to the woman and her family about getting exit doorways cleared for safety. She said she’ll be closing the case, because the woman has a right to live as she wants as long as the neighbors don’t complain about health dangers.
The Orangevale woman, who has owned her home for more than 40 years, explained that she could get everything organized if she had more shelves or could afford a garden shed.
“Where I dropped it, that’s where it stays,” she said of the waist-high towers of stuff. She wondered if her behavior has anything to do with having grown up in an orphanage where she had to share everything.
“I’m not worried about it. It’s mine, and nobody can take it away from me.”
Helping a Hoarder
Here are do’s and don’ts for intervention:
- Make contact face-to-face.
- Use a soft, gentle approach and let the hoarder tell his/her story.
- Treat the hoarder with respect and dignity.
- Remain calm and factual but caring and supportive.
- Evaluate the situation for safety.
- Refer the hoarder for medical and mental health evaluation.
- Go slowly and expect gradual changes.
- Reassure the hoarder that others will try to help and work with him/her.
- Involve the hoarder in seeking solutions.
- Work with other agencies to maximize resources.
- Hospitalize unless there is a clear plan for what this is to accomplish.
- Force interventions.
- Be critical or judgmental about the hoarder’s environment.
- Use the hoarder’s first name unless he/she gives permission.
- Press the hoarder for information that appears to make him/her uncomfortable.
Source: Los Angeles Department of Mental Health, Older Adults Services Division
Reprinted with permission of the Sacramento Bee