Hoarding disorder can lead to a wide range of serious problems. For people who live in the home, these problems can include:

  • Tripping and falling over things
  • Being hurt, or killed, by falling items
  • Developing health problems from mold or pests that live in the clutter
  • Delays in receiving emergency care when emergency workers can’t reach them
  • Injury, or even death, when firefighters can’t enter a home, or control a fire
  • Living without vital services, like plumbing, electricity, and/or heating
  • Eviction following a lease violation
  • Having the home condemned due to unsafe or unclean conditions

In addition to these issues that affect people who live in the home of someone with hoarding disorder, there are other problems for neighbors, building owners, and the property itself. These can include:

  • Public health problems (e.g., spread of pest infestation) for adjacent apartments and homes
  • Structural problems due to too many heavy items (e.g., books, newspapers) that are too much for the load limits of the building
  • Flooding when pipes are in need of repair
  • Fire from electrical wiring or heating systems in need of repair
  • Lost property value and of rent income for landlords who must make costly repairs due to hoarding or who have to pay legal fees (e.g., to end a tenant’s lease)

Some clients with hoarding disorder are motivated to seek treatment on their own.  Others are pressured to seek treatment by court order after inspections from agencies, such as fire and public health departments or the housing authority.

To Clean Out or Not to Clean Out?

Since hoarding disorder can have serious problems, those around the person with hoarding disorder may feel pressure to deal with the problem quickly. Clean outs, while seemingly a quick fix, usually do not work. In addition, clean outs can create strong feelings of loss, anger, or severe emotional distress, and those with hoarding disorder may then turn to getting more items to counteract these strong feelings. Since they have not learned to sort and discard items, even those who do not actively acquire new items eventually have a re-accumulation of possessions.  Further, clean outs are expensive, requiring many hours of labor. Families and agencies, such as local departments of public health, may spend many hours and thousands of dollars clearing the homes of family or community members with hoarding disorder only to find that the problem returns, often within just a few months.

Instead of a clean out, resources are better used to offer treatment to fix the hoarding disorder elements of acquiring and saving that lead to excessive clutter. Family members and friends, as well as housing agency staff and other local agencies that address hoarding disorder, can certainly help. However, they should only help after learning about hoarding disorder and what interventions are likely to work best. It is essential to avoid blaming the person with hoarding disorder before getting involved.

Treatment for Hoarding Disorder

After learning to understand hoarding disorder, cognitive and behavioral treatment can be very helpful.  In this therapy, clients make all decisions about saving or discarding their possessions and learn skills to help them stand the discomfort of discarding, resisting acquiring more possessions, and organizing their homes. In addition, the person learns to correct faulty thinking and beliefs and to manage strong emotions. This will leave them in a position to set rules for what things can and cannot be gotten rid of and to arrange for disposal of unwanted items. It is at this point in the process that others can be of most help in sorting and hauling items marked for removal.