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December 6, 2016

Dealing with Hoarding

Reuel S. Amdur

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Hoarding is a problem faced by many helpers, formal and informal.

Gisèle Grenier Miller, an organizing and relocation consultant, described her work to a meeting of Social Workers in Aging and Gerontology (SWAG) in Ottawa on November 24.  Her work covers several areas: clutter control, chronic disorganization, seniors’ downsizing, relocation, estate sale, and hoarding.

She does not act alone.  Among those services she engages are handymen, clean-up companies, concièrge services (for follow-up and maintenance programs), and therapists.  She has insurance and engages others who are also covered. She receives referrals from physicians, current and past clients, doctors, moving companies, seniors’ groups, contractors, networking groups, and membership organizations.

Hoarders have various characteristics.  There are the typical hoarders who have stuff all over, blocking entrances, furniture, etc.  Then there are shopaholics who buy and buy, sometimes not even opening the packages.  Sentimental hoarders collect items that have special meaning. 

While we would expect to encounter people with serious mental health problems among hoarders, some kinds of hoarders are more likely to have such.  Food hoarders may have food lying around collecting vermin.  Animal hoarders have homes overrun with ill kempt cats, dogs, and other creatures.  Other people have trash and garbage piled up.  There are even people with an accumulation of human waste.

What about books?  Are collectors hoarders?  She suggests that collectors of books or other items have them itemized and catalogued.  Hoarders by contrast have large amounts of items, often of various types, in piles.

So what causes hoarding? 

Some hoarders have Attention Deficit Hyperactive Disorder (ADHD).  Others have Asperger’s Syndrome.  Depression and anxiety may play a role, along with obsessive compulsive disorder.  Trauma and social isolation may be involved.  Miller thinks that genetics have a role.

In engaging a client, she and the client identify needs and limitations.  She outlines her qualifications, including her experience and membership in professional bodies.  Her relationship involves a guarantee of privacy.  She carries insurance for errors and omissions.  The contract carries a cancellation clause.  In the relationship, the client is the boss.

When a new client faces imminent eviction, she attempts to negotiate with the landlord time for her to build a relationship with the client in moving to compliance with the landlord’s requirements.

Miller distributed a “Clatter-Hoarding Scale” published by the Institute for Challenging Disorganization. 

It lists five levels of problems.  Level one appears to be a normal situation.  The next level exhibits some such problems as these: a major exit blocked, visible or odorous pet waste, clutter obstructing some functions of key living areas, odors from dirty dishes, laundry, toilets, etc. 

In level three, outdoor clutter involves items usually kept inside, inadequate sanitation of animals, clutter around exists, entrances, hallways, and stairs, garbage clans full or overflowing, etc. 

It gets worse.  Level four can include, additionally, water-damaged floors, evidence of sewer backup, excessive spiders and webs, rotting food, no linens on beds, mould, etc. Finally, at level five there may be broken windows, extreme infestation by insects, rodents, and other varmints, unusable appliances, human excrement, inaccessible beds, and so on. 

These selected items illustrate what a hoarding consultant may have to deal with.  The consultant will often have to wear protective clothing, even a mask in some cases.  Social workers and other helping professionals may need to see them as allies in cases of hoarding.

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