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  • Helping Hoarders Get Treatment
    Fugen Neziroglu, Ph.D., ABBP, ADAA Member/ Estee Acobas, M.A.
    Bio-Behavioral Institute/Great Neck, New York

Quote:

When a hoarder resists the idea of getting help, a family member may contact a therapist for guidance on effective methods of treatment. One such method is an intervention strategy, adapted by Fugen Neziroglu and colleagues from techniques used for substance abusers.

Family members meet with a therapist several times to learn more about hoarding and treatment options, who should be involved and what to say at an intervention, and how to prepare mentally for what may become an ordeal. They must have the conviction that they are doing the right thing because a hoarder cannot be helped if the family fears anger or consequences of an intervention. Often family members attend a practice session before the intervention takes place.

The goal of those at an intervention is to have the hoarder make one visit to an experienced therapist. At a prearranged time, family members approach the hoarder to talk about the effect of clutter on their lives and explain that help and support are available. Each person explains in a non-confrontational and non-judgmental manner why he or she is concerned. It is important that all participants speak with genuine care, but they make it clear that treatment is mandatory. Arrangements for treatment are usually made before an intervention takes place; ideally a session follows immediately.

Details of an intervention can vary: The consulting professional may or may not be present; it may take place in an office or a home; and the hoarder may or may not be made aware of the upcoming event.

Facing a cohesive group, a hoarder cannot hide or minimize the problem. Intervention is a big step in the right direction, but the hoarder and those involved have much work to do. The hoarder must commit to treatment, and family members must address personal issues and learn to handle issues that may come up as the treatment progresses.

 

 

For families where animal hoarding is a problem:

Book
Digging Out-Helping Your Loved One Manage Clutter, Hoarding & Compulsive Acquiring
by Tamara Hart PhD., Michael Tompkins, PhD.
This book gives manageable steps for helping your loved one make gradual and lasting change.

Powerpoint Presentations:


To open up a dialogue, consider showing them?…:

 

Additional advice collected from various sources. The views, opinions and advice listed do not necessarily reflect the opinions and views of www.childrenofhoarders.com:

 

  • From the Seattle Times:

What to do?
Public resources for helping hoarders are extremely limited. As long as they’re mentally competent and not harming themselves or others, no authority can force hoarders to change. If conditions become dire and extremely unsafe — housing-code violations, rodent infestations, for example — the health department may intervene and order eviction, but it’s rare. To find out what’s available in your community, contact your county’s Senior Information & Assistance Office. You can obtain the phone number from the Elder Locator Office at 800-677-1116,
800-677-1116-www.eldercare.gov.

But most hoarders won’t accept therapy, and none can be changed through force or reasoning. Hoarders are highly anxious people; collecting things decreases their anxiety, which, ironically, reinforces their compulsion because it makes them feel better. The best advice for families and neighbors is to understand the condition as best as possible and try to care about them.

 

Someone helping a hoarder, particularly when this is a family member, must be ready to work within the hoarder’s reality not his/her own. That is, trying to apply normal logic endlessly, assuming that this person will ‘see the light’ if one simply keeps saying the same thing often enough, is likely simply to upset this person and prove, yet again that he or she is, at best, misunderstood, and at worst a hopeless freak.

 

How do you help someone who resists getting help?
Frequently, people with problematic hoarding behavior refuse help. It is tempting for concerned neighbors, friends and family to suggest that redundant articles are given away and useless ones thrown away. However, researchers have found that it is often more effective to focus on sorting possessions before suggesting removal of items. The de-cluttering process can be extremely slow and labor-intensive and is best accomplished if the person with the hoarding problem is able to maintain a sense of control. A few motivational techniques proven to be useful include:

  • Discussions about the daily functions that can’t be carried out because of the clutter
  • Breaking down larger tasks into manageable small areas
  • Choosing target areas so progress is apparent

Since de-cluttering is likely to be extremely stressful, it is important to provide emotional support and encourage open communication about the emotional difficulties experienced during de-cluttering. It may be useful to enlist the assistance of a professional, such as a social worker or psychologist, who has had experience in dealing with people who have hoarding problems.

 

 

How can you help a neighbor or relative who hoards? There is no quick solution. Caring friends must balance the hoarder’s right to privacy against the need to protect them, as well as the respect for freedom versus safety. Most hoarders are lucid enough to understand consent documents that would permit caregivers to step in, and the hoarders often refuse to sign away these rights.

The best approach seems to be slowly establishing a trusting relationship with the hoarder. Make regular home visits that do not immediately address the hoarding problem, but instead enable you to get to know the person and his or her interests. As the relationship grows, the hoarder may be more willing to accept simple offers of assistance. Be sensitive to the fact that the hoarder finds some security in the mess that surrounds him. If you begin clearing without his support, it will only accumulate again.

Some hoarders will not respond even to careful efforts to gain their confidence. They have grown suspicious of others, sometimes justifiably. Dementia often robs a person of her ability to relate to or trust anyone. In these cases, senior service or health care agencies may have to step in to protect the senior. As a friend, your role may become one of helping the senior consider various new care options and selecting the one best suited to his situation.

  • My mom’s a hoarder, what do I do?… Salon.com
  • My wife is a hoarder, what do I do?…Salon.com

 

While they have learned more about the syndrome, adult protective services officials and code enforcement officers acknowledge that they don’t have the resources to provide the case management services that many hoarders need. And, they say, many people who hoard don’t want help.

“Even if we had all the resources in the world, you’re dealing with individuals who might not be amenable to seeking help,” says Debra Morrow, program manager for Sacramento County Adult Protective Services.

For those who do want to change, according to Graff and others, family or friends can help by getting them a diagnostic evaluation, driving them to appointments and prodding them to take the small steps needed to start clearing their clutter away.

“In the end, it’s really hands-on assistance that they need,” Graff says.

Helping Someone Who Hoards

Experts who treat and work with people who hoard say it’s best to:
• Encourage the person to get a thorough diagnostic evaluation. In some cases, people who hoard also have serious conditions such as Alzheimer’s disease, dementia, schizophrenia or a personality disorder.
• Relay concerns independently to a psychiatrist or psychologist because the patient may not be forthcoming about the problem.
• Consider individual or group therapy by someone with experience in hoarding.
• Help the person get to therapy appointments on time and follow through with treatment. Those who treat hoarders say they are often late and distractible.
• Find a friend, relative, professional organizer or coach to help the patient begin removing his or her things rather than discarding items for the hoarder.
• Offer praise for small steps and know that it will take a long time to get rid of hoarded items.

 

 

Although sometimes necessary, simply cleaning out the clutter does not solve the problem: The hoarder will only become intensely anxious and start to accumulate junk again. Legally, social service and community health agencies can do little without permission from the hoarder unless she is creating conditions that are dangerous or detrimental to public health.

What to do?
A lot depends on whether the hoarder wants to change. It’s important to find a good primary care physician, psychiatrist, or neurologist who can determine whether she has a medical or psychiatric disorder. A social service agency may be able to visit the home and assess risk. If the hoarder is safe and her basic needs are being met, she may accept treatment for an underlying illness. Elder services may provide the support she needs to make decisions, organize her possessions, and create a space to live and receive visitors. Family involvement and friendly visits can be a great help.
– Michael Craig Miller, M.D. Editor in Chief

 

 

 

WHAT YOU CAN DO TO HELP A PERSON YOU CARE ABOUT.

INFORM YOURSELF AND TRY TO UNDERSTAND.
Inform yourself to get a better understanding of the problem. Place the “mess” into it’s correct context and don’t simply assume this is the sign of a lazy person. Use this information to show them that help and treatments are available.

 

 

Helping a Hoarder

Here are do’s and don’ts for intervention:
Do:

  • Make contact face-to-face.
  • Use a soft, gentle approach and let the hoarder tell his/her story.
  • Treat the hoarder with respect and dignity.
  • Remain calm and factual but caring and supportive.
  • Evaluate the situation for safety.
  • Refer the hoarder for medical and mental health evaluation.
  • Go slowly and expect gradual changes.
  • Reassure the hoarder that others will try to help and work with him/her.
  • Involve the hoarder in seeking solutions.
  • Work with other agencies to maximize resources.

Don’t:

  • Hospitalize unless there is a clear plan for what this is to accomplish.
  • Force interventions.
  • Be critical or judgmental about the hoarder’s environment.
  • Use the hoarder’s first name unless he/she gives permission.
  • Press the hoarder for information that appears to make him/her uncomfortable.

 

 

One of the main barriers to successful treatment of compulsive-hoarding is that hoarding creates few intrinsic motivations to change. People who hoard tend to view hoarding as reasonable and socially desirable. This is despite the negative effects it might have on their lives (Frost, Krause, & Steketee, 1996).

As a result, people with compulsive-hoarding problems are less likely to enter into and benefit from treatment (Baer, 1994; Ball, Baer, & Otto, 1996).

Loved ones can be immensely helpful by supporting the person’s efforts. This may include letting the person know that his actions are appreciated, commenting on improvements in clutter, even small ones, and empathizing with the person’s struggle using comments such as, “I know this is really hard for you, and I think you’re doing a great job.” Loved ones often think that part of their job should be to throw items away. We tend to minimize this aspect of their role. This is because we believe that people with hoarding problems can best overcome the problem by doing it themselves. Obviously, some items may be large or heavy, and the person will require some physical help carrying them out. But if the loved one finds that they are discarding items while the person with the hoarding problem sits and watches, it is likely that the clutter will begin to grow again as quickly as it was removed.

 

 

 

  • The Ottawa Community Response to Hoarding Coalition:

Those engaged in hoarding, or dealing with a family member who hoards, spoke about what had been helpful, not helpful, and what could be helpful to them regarding what and how services and supports were provided:

  • Provide more homemaker services. Not enough is provided to help;
  • Cleaning companies are helpful for maintenance;
  • Provide long term assistance. One individual could only get that through an on line chat room support group;
  • Provide non judgmental support to family members in recognizing this is too difficult an issue for families to deal with on their own; Only involve support workers and professionals who are well informed about hoarding. Most were frustrated by experiences with therapists who knew little about hoarding. Professional help very important. One spoke of it as being her salvation;
  • Develop a list of treatment provides knowledgeable about hoarding,
  • Consider bartering with a student for assistance with housekeeping in exchange for tutoring or room & board,
  • Suggest sorting items into three piles: keep, toss away, and give away. Allow the person to be in control of what is kept and discarded. Use a storage locker. One individual developed the following list of questions to ask herself during the decluttering process:

Does it lift my energy when I look at it or think about it?
Do I absolutely love it?
Is it genuinely useful?
How much space am I willing to give up for it?
What is enough? Defining what is enough = just the right amount.
Does this object enhance my life?
What’s the worst thing that could happen if I got rid of it?
Are there legal implications for holding onto it? I
f I got rid of it and discovered that I needed or wanted it later, could I replace it?
When was the last time I used it or wore it?
Does it work? If not, do I intend to fix it? If so, when?
Do I like it?
For clothes: Does it fit? Do you have occasion to wear it? Do I have something matching to go with it (for a shirt, pants, skirt, etc.)?

  • Instead of a professional cleaner provide a clutter buddy – someone dealing with the same issues. Create a Clutterers Anonymous similar to the 12 step approach for alcoholism. This is the best way to help, according to one individual;
  • Taking pictures before clean up and after clean up didn’t helpone individual;
  • Concentrate on solutions not how the individual got there. Don’t tell them how bad it is. Suggest a plan of attack;
  • Encourage people to use a shopping list. One individual developed the following list of questions to ask herself when shopping:
  • Am I going to use this object? Is it truly useful?
  • Do I genuinely need this object or do I just want it? Do I already own a similar object?
  • Do I already have enough of this kind of objects?
  • Do I absolutely adore it?
  • What will this object add to my life?
  • Will this object bring me joy and increase my energy?
  • Do I have space to store this object? If not, am I willing to make space for it?
  • Am I willing to look after this object, maintain it, dust it?
  • Can I afford to buy this object?
  • If I were to move, would I bring this object with me?

 

 

 

 

What can I do if my family member or friend seems to have compulsive hoarding?
Individuals who hoard often do not recognize that their behavior is problematic or do not view it as problematic as others do. Change cannot be imposed and raising a person’s awareness of the problem often requires time and patience on the part of others.

While the use of logic and persuasion makes intuitive sense, it is usually not effective for motivating a person to recognize that he or she has compulsive hoarding and to work on the problem. This is because individuals with compulsive hoarding often have mixed feelings about the problem. For example, they may both feel safe and comfortable with their possessions while also feeling shame and embarrassment about their number or their inability to invite others into the home. Attempting to persuade the individual that he or she has too many things and that this is leading to any number of problems (e.g., social isolation, inability to find things, safety and health problems, etc.), usually leads him or her to argue for the opposite position, namely that there is no problem and that he or she is quite comfortable and safe in the home. Instead, raising a person’s awareness and motivating him or her to work on the problem requires an approach in which the concerned family member or friend expresses empathy, elicits the perspective of the person with the problem, and helps him or her to articulate his or her values and goals. Buried in Treasures provides some guidelines for motivating change and Motivational Interviewing, Second Edition: Preparing People for Change, by William Miller and Stephen Rollnick describes in detail this approach to motivating change.

Where there is imminent danger to the person with hoarding or to others in the household and the person with compulsive hoarding is not willing or able to acknowledge this difficulty, it may be necessary for concerned family members and friends to seek outside help. Because compulsive hoarding often touches on many issues, such as mental health, personal safety, and protective issues, it is ideally handled by a coordinated effort among multiple agencies. Concerned family members or friends can find out if their area has a compulsive hoarding task force made up of multiple agencies. For areas without a compulsive hoarding task force, particular agencies can be contacted directly. If at-risk individuals are involved (i.e., children, elders, disabled people, and pets), the appropriate protective service can be contacted; where no at-risk individuals are involved, the local department of public health or the fire department can be contacted.

For individuals with compulsive hoarding who are ready to work in the home and wish the help of family members or friends, the following can be helpful:

  1. Decide together on the goal of the assistance, e.g., clearing an area of the home or accompanying the person on trips to places where he or she usually acquires to help him or her to resist the urge to acquire.
  2. Help the person remain focused on the task in front of him or her. People with hoarding problems often find themselves easily distracted, especially when they are trying to reduce clutter, make decisions about possessions, or resist the urge to acquire things. Family members or friends can be helpful by simply reminding the person what he or she is supposed to be doing at the moment.
  3. Provide emotional support. Overcoming compulsive hoarding is hard work and many people with this problem feel misunderstood. Family members and friends can express empathy, with statements such as, “I can see how hard this is for you,” or “I understand that you have mixed feelings about whether to tackle this clutter.” Family members and friends can also be cheerleaders, for example, by praising the effort the individual is making to overcome this problem and expressing their belief in the person’s ability to make progress.
  4. Help the person make decisions but do not make decisions for him or her. It is helpful to develop rules for discarding. Good questions to ask are: “Is it useful?” “Do you need it?” “Can you do without it?” “In the long run, are you better off keeping it or letting it go?”
  5. Help the person with hauling. Many people with compulsive hoarding have accumulated so many things that they can become overwhelmed by the enormity of removing such a large number of items.
  6. Accompany the person on non-acquisition trips. One way to overcome the urge to acquire is to encounter situations where the urge is invoked and not give in to the urge. This allows the person to experience what happens to the urge when no acquisition takes place. Usually, the urge drops off over time. A family member or friend can support the individual to not give in to the urge in the moment.

In addition to the above recommendations, the following “don’ts” are suggested:

  1. Don’t touch anything in the person’s home without his or her specific permission. Individuals with compulsive hoarding have many thoughts and feelings about their possessions and often feel uncomfortable when another person — even a family member or friend — touches their things. Ignoring the person’s wishes and handling their things without their permission breaks trust and can damage the relationship with them. It can take considerable time before an individual with this problem will allow another person to handle their things.
  2. Don’t argue with the person who has the hoarding problem as this produces negative feelings and slows progress. When conflict arises, take a break. Similarly, don’t work beyond your tolerance level. Overcoming compulsive hoarding is hard work for everyone involved.
  3. Don’t tell the person with the hoarding problem how he or she should feel. While it can be hard to understand why the person is keeping particular things, that seem to be useless, the thoughts and feelings about these things developed for a reason. Respecting that items that appear useless in fact have great value to the person is instrumental in helping the individual to overcome this problem.

Other individuals can also be of assistance in overcoming compulsive hoarding. Cognitive behavioral therapy tailored to this problem is effective. Therapists who are not familiar with this treatment can refer to Compulsive Hoarding and Acquiring. The Obsessive Compulsive Foundation maintains information on therapists across the country who treat obsessive compulsive disorder. To find therapists in your area, visit the OCF’s Online Information Desk.

 

 


In our hoarding clinic and research program, one of the most common inquiries I get goes something like this:

“My [mother, father, sibling, friend, spouse, etc.] has a terrible hoarding problem. But he/she doesn’t seem to recognize that it’s a problem, and isn’t interested in doing anything about it. How can I make him/her see that this is a problem and get the help he/she so badly needs?”

The short answer: In most cases, you can’t. That is, assuming that your loved one is an adult who is legally competent to manage his/her own affairs (meaning he/she has not been declared incompetent by a judge and appointed a legal guardian), and the clutter is not immediately life-threatening, he/she has the right to hoard, even though the hoarding might have terrible consequences for his/her quality of life.

The long answer: Even though in most cases you can’t make the person do anything, you can alter your approach to minimize the likelihood of getting a defensive or “stubborn” reaction. Often, it’s tempting to start arguing with the person, trying to persuade them to see things the way you do. This kind of direct confrontation rarely works. We find that the best way to help people increase their motivation to work on the problem is to start with three key assumptions:

  1. Ambivalence is normal.
  2. People have a right to make their own choices.
  3. Nothing will happen until the person is ready to change

Here are some general principles to guide your conversations:

Show Empathy. Showing empathy doesn’t necessarily mean that you agree with everything the person says. But it does mean you are willing to listen and to try to see things from the other person’s perspective.

Don’t Argue. There is simply no point in arguing about hoarding. The harder you argue, the more the person is likely to argue back. The only solution is to get out of the argument.

Respect Autonomy. Remember, most of you are dealing with an adult who has freedom of choice about his or her own possessions. Try to engage your loved one in a discussion (rather than an argument) about the home and his or her behavior. Ask your loved one what he or she wants to do, rather than just telling him or her what you want: “What do you think you would like to do about the clutter in the home?” “How do you suggest we proceed?”

Help the person recognize that his/her actions are inconsistent with his/her greater goals or values. Ask the person about his or her goals and values. “What’s really important to you in life?” “How would you like your life to be five years from now?” “What are your hopes and goals in life?” Discuss whether or not the person’s acquiring or difficulty organizing or getting rid of things fit with those goals and values. This is most effective if you ask, rather than tell. “How does the condition of your home fit with your desire to be a good grandmother?” “You’ve told me that friendships are very important to you; how well can you pursue that goal, given the way things are right now?”

If you have been accustomed to arguing and threatening and blaming, your new approaches will surprise your loved one and it may take a little time before the person begins to trust you. Try these methods in several conversations and notice whether the balance seems to be tilting in the right direction. If so, be patient and keep up the good work.

 

 

 

Helping Hoarders Get Treatment
Fugen Neziroglu, Ph.D., ABBP, ADAA Member/ Estee Acobas, M.A.
Bio-Behavioral Institute/Great Neck, New York

When a hoarder resists the idea of getting help, a family member may contact a therapist for guidance on effective methods of treatment. One such method is an intervention strategy, adapted by Fugen Neziroglu and colleagues from techniques used for substance abusers.

Family members meet with a therapist several times to learn more about hoarding and treatment options, who should be involved and what to say at an intervention, and how to prepare mentally for what may become an ordeal. They must have the conviction that they are doing the right thing because a hoarder cannot be helped if the family fears anger or consequences of an intervention. Often family members attend a practice session before the intervention takes place.

The goal of those at an intervention is to have the hoarder make one visit to an experienced therapist. At a prearranged time, family members approach the hoarder to talk about the effect of clutter on their lives and explain that help and support are available. Each person explains in a non-confrontational and non-judgmental manner why he or she is concerned. It is important that all participants speak with genuine care, but they make it clear that treatment is mandatory. Arrangements for treatment are usually made before an intervention takes place; ideally a session follows immediately.

Details of an intervention can vary: The consulting professional may or may not be present; it may take place in an office or a home; and the hoarder may or may not be made aware of the upcoming event.

Facing a cohesive group, a hoarder cannot hide or minimize the problem. Intervention is a big step in the right direction, but the hoarder and those involved have much work to do. The hoarder must commit to treatment, and family members must address personal issues and learn to handle issues that may come up as the treatment progresses.

 

 

 

Posts and writing from family members shared with the children of hoarders website. (Thank You!)

 

 

A post from the support group: Messiness & Hoarding from a daughter of a father who hoards, with suggestions on how to help: (posted here with the permission of Sandra Felton, group owner):

Knowing what I’ve learned from this group and other resources, here’s what I would do in your situation:

  • I would not throw anything away unless it’s rotten food or something that will spoil
  • I would emphasize to your mother over and over that you are throwing NOTHING away without her permission; keep in mind at all times that you wouldn’t want people giving away your stuff without asking, and that calling it ‘junk’ or the equivalent may make her defensive. The point of this is to get her trust so that when you go through the things with her, she’ll feel you’re on HER side.
  • Take before photos — nothing helps momentum when spirits start to flag than looking at the progress you’ve/she’s made.
  • I’d sort and organize and put everything that I’d *LIKE* to get rid of into boxes and bins and bags, and store them, even if it means renting a storage unit. I would *not* take them into my own home (could be threatening for her to think you’ve ‘taken’ things; also, sets a horrible precedent of letting her problem lapse over into your life more than it already does. If you can’t afford a storage unit, it may be that you can stack the boxes such that the junk takes up less space that way anyhow.
  • While you’re packing, try to keep like things together
  • While she’s laid up will be the PERFECT time to go through the boxes with her. Be prepared — you can think about this as you pack things — with suggestions for places you can get rid of things that aren’t just trash, that will make her feel good. If there’s any charity or church or neighbors or relatives who could use things, don’t hesitate. With my parents, “I’ll bet Alice could use these” worked much better than “these can go to the Goodwill”
  • When possible, and if you are sure you can get away with it, say you’ll give things a good home and then take them to your place and get rid of them as you see fit.
  • Obviously, you will have to actually KEEP enough of it so that she doesn’t clue in. Or here’s a BRILLIANT scheme — my mother had a zillion trillion baskets: we told her that my sister saves baskets and fills them with goodies and gives them as presents, so we got permission to send ALL baskets to my sisters house, and I’ll bet about 1/4th of them actually made it to her house (the others went to Goodwill and she’ll never know because my sister has given them away as gifts, right?
  • Do anything you can to gently persuade her that this is a problem, not just ‘clutter’ or a need to ‘get organized’. If there’s a doctor or minister or friend who she trusts, who can help, that’s great — if your mother is like my father, she won’t think that her kids could know ANYTHING.
  • Go through the old posts here to see the tricks people here are using on their OWN hoarding problems — take photographs of things and keep the photos in neat albums rather than keeping the things themselves;
  • List things in a journal; help her to think about how good someone who can’t afford
  • New things will feel if they can buy her still-good castoffs affordably at the Goodwill and how that is much better than having them unused for years at her place; and since you (as much as possible) kept like things together you should be able to point out to her that she has 11 turkey basters and can’t possible use more than 1 at a time (so she won’t say “but I might NEED that!”);
  • Remind her that she does need to get rid of things, and that if it takes a week for the first box you’ll never finish — you are donating your time and you’re doing it because you love her and you respect that these are her things, not your things, but she needs to respect that dealing with this is eating up YOUR life;
  • If you’re willing to put on a garage sale then do that (we were not willing to do that).
  • If you have a connection to any charitable group, see if they collect used items, see if they’re planning a rummage sale, tell them you can pretty much supply half a rummage sale all by yourself if they WILL have one — we got rid of LOTS of stuff that way (and if nobody is having a rummage sale, is your town big enough that you could invent a non-existent rummage sale, and give things to Goodwill or take them to the dump?)
  • Be alert for categories of things that she simply CANNOT handle getting rid of — with my father, it was shoes and anything made of cloth. You may have to resign yourself to saving all of certain categories for the moment, say, a couple of hundred towels — but it’s better to keep the momentum going and get rid of things that are easier for her. On the other hand, if you find that there are categories of things that are easier for her to get rid of, ask whether she’ll give you permission to throw all of that type of thing away
  • Remember that getting rid of any tiny little thing may make her just off-the- graph anxious — try to make sure she’s got her favorite tea or cookies or whatever, music, whatever she finds relaxing

Now, if you can do all of that without going nutso bonkers crazy, you are a saint! Do you have siblings who can help? We found that my sister could handle my father’s <anxiety> better than I could, and I could handle my mother’s (own different brand of) <anxiety> better than my sister could — that helped a lot.

That was all written assuming that if you can box things up and make the house presentable enough, she can stay there, with medical staff if necessary.

I didn’t know all this when I started, and we alienated our father by calling his hoard ‘junk’. Also, even though we swore blind that we wouldn’t throw things away, I’m afraid we did, because we were very sure that, given the uncountable number of grocery bags full of milk cartons, they wouldn’t know how many there were, and we got rid of 2/3 of them without asking. We respected that these were THEIR milk cartons, but defined milk cartons as ‘garbage’ anyway. Also, we got into areas of the house that hadn’t seen the light of day for 35 years, and were sure that we could get rid of rusty old fans and things without them remembering they owned them.

 

 

A post from a support group, (Mates of Messies) from a spouse of a compulsive hoarder, with suggestions on how to help. (posted with permission):

My suggestions for talking with a hoarder:

1) Pick a small, doable project. Instead of getting your hoarder/messie to empty all the junk from one room, focus on one part of it. For example, talk about the laundry all over the bedroom and leave the boxes of books, newspapers, magazines, broken electronics, etc., for another day.

2) Time it right. Just had a big fight about the laundry? Not the right time to talk about it. Instead, try for a time when your hoarder/messie is feeling really good about him/herself — just had a success at work, made a delicious dinner or whatever it is.

3) Make your case calmly and rationally. Focus on what good will come from getting the project done. Example, “Honey, won’t it be nice to know exactly where your favorite T-shirt is?” (Leave the fact that the shirt is a high school leftover for another time.)

4) Set goals together. While for you sorting the laundry may be a ten minute job, a hoarder/messie needs more time to make decisions and to them just distinguishing between dark and light laundry may be hard. Take this into consideration when making goals but also don’t let the messie/hoarder set the entire timeline.

5) If you have little kids and can afford it, get a babysitter or a friend to watch them while you and your significant other work on the project.

6) Write it all down. I can’t emphasize this enough. It seems nit-picky but is necessary. Have a timeline in writing, get your messie to sign and date it. Follow through with any consequences. Using the laundry example again, if the laundry isn’t sorted, washed and put away by X date, it will be sent to Goodwill. If you don’t follow through, all your other work is in vain.

7) Celebrate a job well done! Sure, it seems like doing the laundry isn’t all that big a deal. Some of us do it every day without even thinking about it. But for a messie/hoarder, these small everyday tasks are major projects that require a lot of mental energy.

Good luck to everyone!

 

 

 

A letter written to a mother who hoards, February 2006.

Dear Mom,

Here’s what I used to think:

“My mom is so messy! Why can’t she keep a nice house like “normal moms”, like my friends have? Why does it have to be a “pig sty” all the time? I just don’t understand why she can’t just be neat and tidy like other people!”

What I know now:

You’re Not Lazy

Each thing is unique to you and can’t be replaced. You can’t just “put it away” because you really have to figure out where you mean for it to go. For example, if you look at a cookbook and there is an interruption, it can’t be put back as it’s in a new category such as “actively being read”, so it goes to the back of the couch or somewhere close by so you can see it and not forget it.

Then, you may look up a word in a dictionary but can’t put it back on a shelf because you might think you’ll forget the word. This could go on with many different kinds of books/magazine articles/recipes, whatever, until they all have a new position in the room. And that position has a meaning to you. It’s a way of organizing that looks like chaos to other people.

Because you may think this way about EVERYthing, not just books and magazines, the decision making process on where to put things is overwhelming. When you bring home new things, sometimes it’s easier to just “plop it down” than deal with the draining process of what category it should go in right now.

“Every, single time I spend my coveted time off clearing paths, becoming exhausted from the effort of trying to make my mom’s living environment nice, getting optimistic she will have a nice place to live now, have friends over….she fills it up again. Every time. She must think I have nothing better to do with my time then to spend my life cleaning up the clutter she creates”.

Churning Is Not Just For Butter Anymore

When you organize things like you do, and you keep acquiring new things, space just runs out which leads to piles. When you try to sort a pile, you might not be sure what to do with something that moment (because it’s so mentally taxing) and think “I’ll set it here for now”, and you put it somewhere nearby.

Every time you pick up something and examine it, you may feel like its value increases. Therefore, it may get a new category to you so you put it on another pile or reposition it in the old pile and where you put it has significance to you. As a result, nothing really went anywhere, it just took a little trip. Over <two> million other people in the U.S. do this too, they call this moving around of things “churning”. You aren’t alone.

When this goes on over time, the piles you’ve made merge into a large pile. So you may have me do it for you, but the end result is still the same.

“What is wrong with my mom?! She has really important stuff in piles with useless things! Doesn’t she have enough sense to know that mail from the bank shouldn’t be in the middle of a pile of a pinecones, empty plastic bags and old newspapers?”

Cash & Trash-Pile Anatomy

Trying to decide how to organize <I know decision-making is difficult for you> or throw away based on the value of a certain thing is hard because everything is equally important to you. That is why you may have things other people consider “trash” in piles with important paperwork, mail, etc.

Because you have a lot of things equally important to you in the same pile, EVERYthing has to be examined closely. You may even have cash mixed in with what other people consider “trash.” It’s not that you don’t recognize the value of cold hard cash, it’s just that it’s just as important to you as the other stuff in the pile.

The File Clerk Was Fired

You might think that if you file something and it is out of sight, you might forget it. You like to see everything and feel that filing just hides it. You might not have much confidence in your memory. One lady said that even though her papers were given an elaborate filing system, she felt like they were lost to her, even though she could locate them now.

You like to remember where everything IS where the rest of us only have to remember the system. <i.e.-cash in a wallet, books on the shelf, etc.>

“Why does she have to keep the old junky cars that are no good from people who have died?
Why is she saving those thousands of garbage ties my grandfather had?”

A Sentimental Journey

You may save things for sentimental reasons. Like everyone else, they might be a meaningful reminder of past events. However to you, a lot of ‘unique’ things have this kind of significance and they may feel like an extension of yourself or other people…especially those deceased. Getting rid of some things might be like the loss of part of yourself or a close friend.

“Why does she get so mad at me when I’m just trying to help clean? Other parents would love that their kids are cleaning for them but my mom just gets mad at me. I must be pretty bad if I get yelled at just trying to be good. Why can’t she say “thanks” or “Good job!”?

MISPLACED THINGS/DISPLACED ANGER

Some <other people that save like this> say they feel violated when other people touch or move their things…like they lose their importance if other people touch them. Some say it’s like their things become contaminated if touched and they can go into a rage, like they are trying to defend the value of the “things”. You like to have control over them. <they are important to you. They may represent what you WANT your life to be like-your hopes and dreams.> You may feel that your “things” are the only thing you DO have control over in your life and maybe you don’t want to lose that one thing you feel confidant about.

Dare I Say Womb?

You might save things because it makes you comfortable having them around you. One hoarder wrote that “I just want to go home when I’m out and just have my things around me because it’s comforting”.

Never Have To Say Goodbye

You might not want to get rid of things because you don’t want to lose something that might be needed someday by you or others. Like with old newspapers, you don’t really care about the paper itself, but the information in there. <you might feel like it’s YOUR RESPONSIBILITY to know the information in there.>With junk mail it may be a lost opportunity. Used envelopes with notes on them might represent a part of your life or a day you don’t want to forget. If you save these things, you avoid losing the information (e.g.-newspapers),forgetting what happened that day(e.g.-envelopes with notes with what you did that day) as you don’t want that those things lost to you forever.

When you buy things that other people might think are frivolous, to you it may mean you don’t want that good bargain to be lost to you forever that you can’t get back. <You might be saving something for the perfect recipient who will value the item as much as you do.>

Deciding What Decision The Decision Is In

Making the decision about what to do with your things is the hard part. There have been <brain imaging> done that show different patterns in the area that deals with focus, attention and decision- making in those that hoard. Putting things in a pile to sort later avoids the discomfort of making a decision that is very real. <Feeling that “punishment” feeling.> That might be why you avoid it. Some say that avoidance IS the compulsion with hoarding.

PURFEKSIONISM
Did it bother you I didn’t spell that perfectly?

You may not want to make a mistake. An item may have a use some day and what if it’s thrown out in error? It’s that perfectionism thing-the fear of making the wrong decision that you can’t change.

Waste Not, Want Not
No really….not in the WASTE, over here on this pile

You may feel guilty about wasting things. An item may have a use some day, no matter how remote it is. Some <compulsive savers> say ownership carries with it a responsibility to use a possession properly. <In a way it’s like>”Trying To Save The World”.

You may not want to lose control over what is saved or thrown away (you’re not ready to deal with it yet) so you guard your things in many creative ways.

Not Tonight I have a Pile-Ache

You might fear social interaction. Things are safe…they don’t hurt your feelings, die or disappoint. Having a home full of things may be a protective mechanism so you don’t have to engage with others. Having the excuse “there’s no place to sit” or you have to “sort through the things” gets you off the hook from having people over or doing things that may be unpleasant to you. <Don’t be scared. We’ll respect your boundaries.>

So I’m sorry about all the anger I’ve had. But my feelings matter too. I just never understood before. Please know that there is hope and people do get better.

Love, Your Daughter

 

 

 

From a daughter trying to help her mother:

Blitzkreig cleaning

I will give you my 2 cents. I am using the book “Buried in Treasure” as a resource and a dialog starter for me to work with my mom. I went through all the exercises they provide in the book with her which can be an eye opener to both the child and the hoarder.
Now the house was absolutely full. waist to chest high with 3 storage units rented out and a tent full outside (don’t ask). You have to have room to start so I began my clean up. I bought 8 boxes of contractor garbage bags and about 200 18 gal. plastic bins of the same type to stack. I am cleaning a single family home so I can store trash out back until I can call for a big dumpster. I started in on the piles with a trash bag, a keep bin, mixed paper bin (you know you need one) and a newspaper bin for recycling. I eventually added another bin for personal correspondence as I feel that is justifiable to keep.

I let the hoarder go through the trash but I use it as a teaching point. “Why are you going through this?” and “1% of this is probably worth keeping but you are using 90% of your time looking for it” as well as “If something is stolen it is gone and you can’t use it, if something is buried and you didn’t know you had it you can’t use it” I also had the hoarder write a letter to all the people she cared about explaining why the object was more important than her health, safety, and families well being.

Once there was some clear space I had her come up with up to 30 categories of stuff she wanted to keep. We then visualized the house being clean and where we would keep each of those categories (write this down cause they will forget) I then estimated how many bins of volume could be stored in those spaces and recorded that as the limit for those categories. i.e. decorations 14 boxes, linens 5 boxes.

Because she has multiple health problems I set up a chair in the middle of the room and stacked 2 of the save bins that I had gone through in front of her. Closest to the chair are the trash, recycling, give away and sell boxes. surrounding those is one box from each of her categories. When 1 box is filled the lid is put on and another stacked on top.This provides a visual cue of how much they have in that category.

Most important is allowing them to set reasonable time frames for disposing of sell and giveaway items. Recording those time frames and enforcing them. She has said by X mas for all give away items and 4 garage sale days for all sell items.

We also discussed rules for paper before I started cleaning. No newspaper more than a week old unless it is a clipping of a friend/ family. No magazines over a year. No bills more than a year. All personal correspondence will be saved as well as all tax info. This allowed me to get rid of 95% of all paper which is easily a third of the clutter.

Once she got the hang of where the keep categories were her sorting speed increased. We still have a lot to do but she is making progress. This evening she went through 7 bins, a new record. Better still is that she is getting rid of about 50% of all items.

She has stated that she never worked on it because she feels overwhelmed so I use the containers of items that she has designated to go as a visual reminder of her success. I reinforce that by having her look at that amount of plastic containers so that the progress is tangible.

THE GOOD
She see’s the system and is making real progress
It is easier for her to sort when sitting and comfortable
Everything has a place (container) even if the rest of the house isn’t clean

THE BAD
When I asked her today what her reason/goal for sorting was she stated it was so I wouldn’t be mad at her. What I was looking for is that so she could have a clean house or be in a safe living environment, etc. etc. It looks like I will need to reinforce her goals that we discovered in the book. There has been some F U’s and G damn you’s thrown at me but I reminder her that the real reason she is angry is that I am forcing her to face her disease. Then I calmly drive to my cousins house and drink a beer and vent to him;)

PS There is over 200 contractor bags of garbage in the back yard, she has looked through 10 and pulled an old umbrella out as well as a Halloween decoration. I was playing on the overwhelming feeling to keep her from looking through all the bags. I did the math for her that after 3 weeks and only seeing 10 bags It would take her 60 weeks to go through all the garbage…..She has made it 2 weeks without going through another bag.

 

 

We’ll wrap it up with a quote:

It is not really a problem, maybe an eccentricity, unless we see the other two features of the definition:

Living spaces so cluttered that using the room as intended is impossible.

The third defining feature is significant distress or impairment in the ability to function.

People experience distress at the possibility of throwing things away, and at the Herculean effort it would take to clean up the house.

They develop avoidance to decision-making and discarding.
They avoid putting things out of sight.

We think hoarding behavior is in large part an avoidance behavior.

-Randy O. Frost. Ph.D., Speaking to the New York City Hoarding Task Force, 94.

Permanent link to this article: http://childrenofhoarders.com/wordpress/?page_id=1682

  • Some valuable advice sent in by a paramedic, from the site SqualorSurvivors.com

    Paramedic tips

    Here’s hoping that this situation never arises, but if you or another member of the household has an accident or falls ill, you may have to call a paramedic for assistance. There is no mess so bad that the occupants should have to suffer without medical care. Fortunately, we have a member who is an emergency medical technician, and she shared with us some tips for making the whole experience of having an EMT enter your home as smooth and painless as possible.

    Hints to help you prioritize:

    1.  If anybody is taking a lot of medications, it’s very helpful if they’re where they can be scooped up and handed to an EMT or medic. This can be hard if the way you’ve learned to take your medications is to store each bottle someplace where its presence will remind you to take your medication. I’d urge anybody to come up with a system for being able to easily get medication information to EMS responders. It can be a list or a bag full of empty bottles that have current information on them, or ANYTHING that will give the EMS workers up to date and accurate information. But a bag with all the current med bottles in them is best — it has all the information on we need, plus the phone number of the patient’s doctor and pharmacy in case those are needed.**

    2.  The easiest path for you to go in and out might not be the best path for the EMTs. My mom and dad, for example, use the side door because it’s nearest to where they park their cars and takes them into the kitchen where they can put down their packages. But the best way in and out for an ambulance crew is the front door — fewer steps and no tight corners. When my dad had his stroke, Mom was having to get plants and empty flowerpots and wind chimes out of the way. So try to keep a clear path in and out through the exit that makes the most sense for EMS responders. And try to have a clear path from there to the street or driveway. And if they can back the ambulance up almost to the door, so much the better!

    3.  If there is a large person living in the home, remember that it might take a lot of people to remove them from the home. We’ve had to get four firefighters to help us move some patients. Will there be room for that many people to move around?

    4.  As a courtesy, please let EMS responders know if they won’t be able to get in and out with the gurney. You can either tell the 911 operator, or have somebody meet the ambulance and tell them something like, “There are a lot of tight corners between the patient and the door,” or “The house is pretty cluttered, they might want to check it out before they bring the gurney in.” It’s no fun to haul a gurney up the stairs to a house only to find out you can’t actually use it. And it takes unnecessary time, because then you have to move the gurney out of the way and go back to the ambulance for an alternative. EMS crews DO have gear to get people out of tight spots. It’s nice to know in advance that we’ll be using them. For example, one home had very tight staircases and the only path to the ambulance took us between two buildings very close together. Since we knew that, we just left the gurney in the unit and brought in a specialized spine board.

    5.  Even if Fido doesn’t bite and Fluffy doesn’t scratch, try to have somebody scoop up pets and get them contained in another room. Once we were struggling to get an IV into a patient who was thrashing violently, and a kitten was trying to play with my shoelaces! Cute kitten, but I’d rather not have met him under the circumstances.

    And although they’re human, remember that EMS workers see people’s houses as they REALLY keep them, so they are aware of the secret squalor that folks manage to hide from everybody else. Your house is not the first messy one they’ve been in. They’re concerned about the well being and safety of their crews and the patient, not about your housekeeping.

    Contributed by Granny Grump 42

    **

    Here, you can go to the hospital, or I’m sure the doctor’s office might have some, and get a bottle. In this bottle is a piece of paper that you fill out with the person’s name, any problems they might have (diabetes, heart problems, etc) and any medication they take. Then you store the bottle in your fridge door. The bottle is accompanied by a sticker you put on the front door or a window by the front door so the paramedics are aware you have the information and they know where to find it. I’m sure other places have it and it’s just a matter of asking your doctor about it.

    Sometimes in the rush of the moment, things can be forgotten so it’s a handy way for the information to be available and since anyone who uses this system is advised to put it in the fridge door ONLY, EMT’s can find it immediately.

  • Some valuable advice sent in by a paramedic, from the site SqualorSurvivors.com

    Paramedic tips

    Here’s hoping that this situation never arises, but if you or another member of the household has an accident or falls ill, you may have to call a paramedic for assistance. There is no mess so bad that the occupants should have to suffer without medical care. Fortunately, we have a member who is an emergency medical technician, and she shared with us some tips for making the whole experience of having an EMT enter your home as smooth and painless as possible.

    Hints to help you prioritize:

    1.  If anybody is taking a lot of medications, it’s very helpful if they’re where they can be scooped up and handed to an EMT or medic. This can be hard if the way you’ve learned to take your medications is to store each bottle someplace where its presence will remind you to take your medication. I’d urge anybody to come up with a system for being able to easily get medication information to EMS responders. It can be a list or a bag full of empty bottles that have current information on them, or ANYTHING that will give the EMS workers up to date and accurate information. But a bag with all the current med bottles in them is best — it has all the information on we need, plus the phone number of the patient’s doctor and pharmacy in case those are needed.**

    2.  The easiest path for you to go in and out might not be the best path for the EMTs. My mom and dad, for example, use the side door because it’s nearest to where they park their cars and takes them into the kitchen where they can put down their packages. But the best way in and out for an ambulance crew is the front door — fewer steps and no tight corners. When my dad had his stroke, Mom was having to get plants and empty flowerpots and wind chimes out of the way. So try to keep a clear path in and out through the exit that makes the most sense for EMS responders. And try to have a clear path from there to the street or driveway. And if they can back the ambulance up almost to the door, so much the better!

    3.  If there is a large person living in the home, remember that it might take a lot of people to remove them from the home. We’ve had to get four firefighters to help us move some patients. Will there be room for that many people to move around?

    4.  As a courtesy, please let EMS responders know if they won’t be able to get in and out with the gurney. You can either tell the 911 operator, or have somebody meet the ambulance and tell them something like, “There are a lot of tight corners between the patient and the door,” or “The house is pretty cluttered, they might want to check it out before they bring the gurney in.” It’s no fun to haul a gurney up the stairs to a house only to find out you can’t actually use it. And it takes unnecessary time, because then you have to move the gurney out of the way and go back to the ambulance for an alternative. EMS crews DO have gear to get people out of tight spots. It’s nice to know in advance that we’ll be using them. For example, one home had very tight staircases and the only path to the ambulance took us between two buildings very close together. Since we knew that, we just left the gurney in the unit and brought in a specialized spine board.

    5.  Even if Fido doesn’t bite and Fluffy doesn’t scratch, try to have somebody scoop up pets and get them contained in another room. Once we were struggling to get an IV into a patient who was thrashing violently, and a kitten was trying to play with my shoelaces! Cute kitten, but I’d rather not have met him under the circumstances.

    And although they’re human, remember that EMS workers see people’s houses as they REALLY keep them, so they are aware of the secret squalor that folks manage to hide from everybody else. Your house is not the first messy one they’ve been in. They’re concerned about the well being and safety of their crews and the patient, not about your housekeeping.

    Contributed by Granny Grump 42

    **

    Here, you can go to the hospital, or I’m sure the doctor’s office might have some, and get a bottle. In this bottle is a piece of paper that you fill out with the person’s name, any problems they might have (diabetes, heart problems, etc) and any medication they take. Then you store the bottle in your fridge door. The bottle is accompanied by a sticker you put on the front door or a window by the front door so the paramedics are aware you have the information and they know where to find it. I’m sure other places have it and it’s just a matter of asking your doctor about it.

    Sometimes in the rush of the moment, things can be forgotten so it’s a handy way for the information to be available and since anyone who uses this system is advised to put it in the fridge door ONLY, EMT’s can find it immediately.