Over a lifetime, your parents may have accumulated some treasured possessions and mementoes—photo albums, furniture, fine china, knickknacks, souvenirs, newspaper clippings, and the like. However, when does holding onto prized possessions from the past turn into a troubling hoarding disorder? And what can you, as an adult child, do to help?
“Hoarding is when you are in incapable of discarding things, even things that you and most reasonable people would consider to be garbage or junk. You have a pathological need to keep those things,” says Adrian Walter-Ginzburg, PhD, president and CEO of Caring Transitions of New York City, an estate management company that handles estate sales, senior relocations, downsizing, and decluttering.
Even at a moderate level, hoarding can be disruptive to an individual’s life and to the lives of family members around them. In its most extreme form, the clutter and chaos can cause a threat to health and safety.
“Whether people can manage their medications starts with whether they can find them,” Walter-Ginzburg says. “Also, EMTs, medics, and firefighters may find it difficult to enter the house of a hoarder. There might not be an aisle big enough to allow a gurney to get through.”
In New York City, with people living in close proximity, hoarding can cause biohazard and sanitation issues, Walter-Ginzburg observes. Clutter and accumulation of garbage can attract mice, vermin, and other pests, which can infest nearby homes. Stacks of newspapers and magazines can cause a fire capable of spreading quickly.
“People have a right to self-determination, including a right to live in squalor,” Walter-Ginzburg says. “However, that right ends when their behavior has implications for an entire neighborhood.”
Signs of a Hoarder
In her experience with hoarder organizing and cleanout, Walter-Ginzburg has come across numerous resources that identify hoarder behavior. She points to a valuable tool developed by the Institute for Challenging Disorganization: The Clutter-Hoarding Scale™. The scale identifies five color-coded levels of hoarding, ranging from Level 1 (“Green”), in which there are no excessive clutter or sanitation problems, to Level 5 (“Red”), indicating the most extreme hoarding problem. Level 5 hoarding, identified as a severe, is characterized by extreme indoor/outdoor clutter that blocks exits, entrances, hallways, and stairs; rooms throughout the home unable to be used for their intended purposes; poor animal control and sanitation; and other hazardous conditions. Cleanup of such an extreme hoarding situation would require full personal protective equipment (PPE).
To varying degrees, the middle levels of the scale also are characterized by health, sanitation, and safety problems created by excessive clutter. For a complete list of the conditions associated with all five levels, download a free PDF at the ICD website).
“One thing to keep in mind is that hoarding is a psychiatric condition,” says Walter-Ginzburg. “Two years ago, in May 2013, hoarding disorder became an official mental health condition listed in the DSM-5 Manual of the American Psychiatric Association.” Prior to that classification, hoarding was considered to be part of obsessive-compulsive disorder (OCD).
Citing the DSM-5, Walter-Ginzburg reports that hoarders have a conscious ongoing urge to accumulate more possessions, experiencing feelings of anxiety and mental anguish when those possessions get thrown away. “You haven’t seen a freak-out until you’ve seen a hoarder freak out about throwing away a bank statement from 1975,” she says.
Most of the items that hoarders keep have limited value, such as old magazines, flyers, and junk mail, Walter-Ginzburg confirms. “The junk and the garbage becomes equally as important to them as fine Tiffany china. I’ve seen people with piles of newspapers who say, ‘There’s an article somewhere in there that I want to read.’ Meanwhile, they’re endangering the whole neighborhood with these 6-foot stacks of newspapers.”
Another characteristic of the disorder is that the accumulation of this junk prevents the normal use of space. “Many people sleep in chairs or even the bathtub because they have no other place to sleep. They can’t use their kitchen. They may have something they need in their closet, but they can’t open it,” Walter-Ginzburg says.
Additionally, the disorder causes disruption in major portions of their life. “They can’t have families over, they can’t find clothing to go to work, they can’t sit in their kitchens and have a cup of tea,” Walter-Ginzburg reports. “It affects their interaction with the rest of the world. There are adult children who tell their parents, ‘My children will never visit you. It’s too dangerous.’ Couples break up over it. The spouse will say, ‘I can’t live like this. I have to leave.’ ”
How to Help a Hoarder
Because hoarding is such a deeply ingrained disorder, it’s very difficult to overcome. However, Walter-Ginzburg suggests that adult children of hoarders can intervene by helping them get organized, in some cases hiring a cleaning service or a professional organizer like Caring Transitions.
“With hoarding, there is a lot of backsliding,” Walter-Ginzburg says. “People go back to their old habits. The minute we go away, the hoarding starts all over again. The only solution may be to hire a cleaning person or organizer to come in on a regular basis. You can’t expect a hoarder to keep up with this on their own. Once the initial cleaning, organizing, and decluttering is finished, you need to make sure that it’s an ongoing process so that, once the home is clean, it stays that way.”
Stay tuned for an upcoming #ElderCareChat session about how to help hoarders…