Society of Certified Senior Advisors: When Your Parent is a Hoarder

What to do (and what not to do) if you have a parent whose house is filled to the brim.

Hoarders buy and keep things that they don’t use, and often form strong attachments to those things, even if they are useless to most people. In extreme cases, rodents may enter the home and take up residence. The hoarding may extend outside to surrounding property and include autos that quit running long ago, rotting lumber and other materials.

Some people hoard animals, often acquiring dozens or even hundreds and ending up with a house and/or yard full of neglected animals, urine and feces. Hoarding makes quality of life worse, not better, yet the hoarder usually cannot understand that and insists on keeping everything. An adult child will struggle to understand why this is happening and what to do about it.

"It's a problem that's coming out of the woodwork, especially with the older adult population," says social worker Susan Hoskins, executive director of the Princeton Senior Resource Center and its hoarding task force. "As a therapist I have found very few things that are as difficult to treat … and so hard for people to give up." Hoskins says she often gets desperate calls from grown children of hoarders asking, "What am I going to do about this?"

Who has Hoarding Disorder?

If you have a relative with hoarding disorder, you are far from alone. Nearly 6% of the population hoards. Hoarding is a mental illness linked to depression. About 15% of older adults who have depression are extreme hoarders. The Mayo Clinic writes that symptoms of hoarding disorder might include the following:

Getting and keeping things you don’t currently have a need or space for.
Continuous difficulty parting with things, regardless of their value.
Feeling the need to hold onto items and being upset when you think about getting rid of them.
Building clutter until you can no longer use rooms.
Being a perfectionist and avoiding or delaying decisions.
Problems around planning and organizing.

Hoarding disorder is different from collecting. Collectors hunt for specific items to put in organized displays. They don’t cause distress or problems functioning in daily life. Hoarding disorder is characterized by disorganized piles of things such as clothes, paperwork or books that crowd living areas, spilling onto countertops and tables. It may become impossible to cook in the kitchen, while tiny pathways serve to navigate the home. People with hoarding disorder may avoid social activities and have trouble with nutrition, hygiene and medication.

What Brings on Hoarding Disorder?

We know that hoarding may be a side effect of depression or anxiety. Scientists have discovered that many hoarders grew up with a parent who hoarded. Seniors may hoard to feel in control when physical and mental facilities are failing them. Hoarding disorder can be triggered by the loss of a loved one. It can also be linked to dementia. Researchers believe that a mix of environmental and genetic factors contribute to hoarding disorder.

Symptoms of hoarding disorder may begin in a person’s teenage years. They may get and save more things than they have space for. As time progresses, living areas become more cluttered. By middle age, symptoms may become more embedded and the clutter can become heaps and mounds of items that will never be needed or used.

Dangers of Hoarding Disorder

Hoarding can lead to unsafe conditions, especially for senior adults. Stacks of old papers are quick to burn, but the fire department may not be able to get in the house or even find the occupant. The same holds true if the hoarder has a heart attack; emergency personnel will struggle to reach them and provide life saving care. Cluttered floors present tripping hazards, and mold or feces create unsafe living conditions.

How to Help

If you have a loved one with hoarding disorder, helping to break the hoarding cycle will take time and plenty of patience. Cleaning up the home without their consent will likely cause the hoarder to become angry and distressed, and it does nothing to break the cycle of excess accumulation. Admonishing someone who hoards will result in a loss of trust, and trust is needed for the hoarder to feel in control.

Denying the problem and resisting change are common, says social worker Henriette Kellum, who adds, "To them, you're the problem."

Remember that hoarding is a mental health issue, not a choice. Professional senior move managers may be able to come in and help guide an older adult who is hoarding. A last choice is to simply come in and get rid of possessions, but this may be necessary on a limited basis to ensure safety from falls.

Treating hoarding disorder can be a long process. First, check with the older adult’s doctor to make sure dementia isn’t the cause. Have the senior evaluated for depression and anxiety. Treatment may include:

Anti-anxiety and antidepressant medication
Group therapy with family support
Cognitive behavioral therapy and skills training

Set small, achievable goals, such as cleaning the top of a bookshelf. Clearly and often tell your parent that you respect their decisions. Be willing to go slowly. Celebrate small victories, like removing a single bag of clutter.

When You Must Clean Up a Hoarded Home

If you must get a hoarded home cleaned out, one option is to hire a professional organizer. Most of these will separate items into three piles: donate, throw away and keep. Clarify how much can be kept, such as 5%. If there are valuables, you may want to check if your organizer can add a pile for those and knows someone who will sell them online.

Check to see if there’s someone who specializes in senior hoarding in your area by googling “professional senior hoarder clean out” or similar. If the home is really trashed and nasty, you may need to opt for a service such as crime scene cleaners that will pull everything out and disinfect what is left.

If you’re dealing with a parent who has hoarding disorder, don’t despair. If possible, get counseling yourself on how to deal with this unwelcome situation. Check out Children of Hoarders organization. You are far from alone.