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When Clutter Becomes Chaos: Elder Hoarding

Legal intervention may be needed to assure a loved one’s health and safety

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My grandmother and great-grandmother emigrated from Albania 100 years ago. They lived in a cave while waiting for safe passage to America, and arrived on Ellis Island with nothing more than their documents, the clothes on their backs, homemade afghans and lice they picked up on the ship. My grandmother worked every day of her life — through the Great Depression, war, marriage, divorce and single motherhood. She raised my mother to not waste a single thing, fix what was broken and be thrifty. Everything was saved in case of a rainy day.

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An ‘unfortunate inheritance’

My mom rose above the austere upbringing. Despite the odds, she received a Ph.D. She made a decent living and could afford luxuries her mother had never known. But the “save everything” mentality was ingrained. And when she died — boy, howdy, did I have my work cut out for me to clean out her home. The woman kept everything. She had a spare bedroom full of boxes (some hadn’t been opened since her own mother died). Scads of dry cleaner’s hangers, hundreds of glasses, a thousand restaurant ketchup packets and a closet of stockpiled toiletries. Her home was precisely organized, but it was still a mountain for a grieving daughter to climb. It took four months for me to break it all down, and even then, I put most of the boxes in two storage units. Those took another year to go through and separate into “keep,” “donate” and “why didn’t any of my ancestors throw this away already?!” categories.  

I believe my mom’s tidiness and cleanliness kept me from calling her a hoarder. But I also believe that she had more possessions than she could ever need or use, even if she had lived another 10 years. And I know that there was no chance she would ever have decreased the overwhelming amount of stuff in her house. The piles were only likely to grow as time went on. And it all would be destined to become an unfortunate inheritance for me.

Health and safety hazard

In my career working with older adults and the infirmed, I regularly see cases where it’s revealed that the client or a family member is a hoarder. It’s more common than we think and can happen to people of any background. It’s estimated that 3 to 6 percent of the population are hoarders; that’s about 19 million people. Hoarding ranges from an overstuffed home that’s become an issue for the residents to move around in safely to a filthy hovel with trash piled up in the corners and every surface buried. Hoarding at any level can lead to a variety of health risks. A person may be more likely to trip or fall over piled-up belongings; stacks of paperwork or blocked electrical outlets create fire hazards; mold can grow in dark, damp spaces; and the neglect can cause unhygienic conditions for the human and animal residents.

If you’re asking whether a situation you’re living in or have seen in another’s home is hoarding, you already have your answer. And now’s the time to act. The first step is to assess the person or people whose living conditions are affected. If you are the one hoarding, do you know the reason why? If you’re observing hoarding in another, find out if they are they aware of the problem and open to help. Approach this with respect and compassion. Shaming or blaming ourselves or another never helps, no matter the circumstances.

The root cause

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A person can begin hoarding because of that “rainy day” mentality or due to financial instability, depression or anxiety, addiction, or mental or physical limitations that prevent them from the keep and care of the home. Cognitive decline or dementia can prevent a person from managing their household the way they once did. But whatever the cause, getting help is crucial for the safety and quality of life of the people living in a hoarding house.

A physical or mental health assessment can help get to the root of the situation, so make appointments with a licensed mental health professional and a primary care doctor. A combination of therapy and medical treatment can improve the hoarder’s well-being.  

If possible, endeavor to clean up the property to mitigate health risks and the home’s deterioration, but do this only with the household’s participation or the proper legal authority. No surprise cleanouts! Hire a service (there are companies that specifically handle hoarding homes if the problem is above an average housecleaner’s scope) or enlist the assistance of able loved ones. Understand that a one-time clean isn’t a long-term solution. Often once a house has been cleaned, the situation will devolve and then become chaos again in short order.

The sustaining plan is part of a holistic collaborative effort. Specialized support is required to meaningfully help a hoarding household. A geriatric care manager or in-home companions can be hired; regular housekeeping services can be employed to tidy and do deeper cleans; the family can create a family contract to divide up tasks among relatives and loved ones who can chip in; and family, friends or neighbors can provide shopping assistance and regular check-ins to stave off over-purchasing and disorder.

Legal intervention

If it’s not possible to make headway with the mess, if the living conditions are severely dangerous, or if the residents of a hoarding house can’t or won’t accept help, more social and legal intervention may be required.

If you are caregiving for someone who created legal documents for their life-care planning, first reread those documents to see what they empower you to do and discuss them with the lawyer who prepared them. You may be able to step up your level of participation without involving the courts or government agencies.

Absent that, you may need to involve the authorities or court system to get the hoarder the help that’s needed. For example, a call to Adult Protective Services or the area’s senior services officer can prompt a social worker wellness check. If the conditions or behavior is life-threatening, contact emergency services without delay.

Alternative dispute procedures like eldercaring coordination or elder mediation may rally the troops to get a low-functioning older adult’s needs met. If a person has become incapable of managing their affairs to the point that they are creating imminent danger to themselves or others, asking a court to be their guardian may be the next step. A legal guardian can make decisions on behalf of the incapacitated person and act in their best interests.

Ultimately, hoarding and its associated physical, mental, financial and emotional limitations may mean that aging in place or living independently is no longer a viable choice. A move to another space may be the next logical step. A change of residence, coupled with medical and social support and intervention, can drastically improve the life of a person who can no longer manage on their own.

Amanda Singleton is a recipient of's national Caregiving Visionary Award and serves caregivers across their life span through her law practice. Follow her on Twitter and Facebook.

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