When hoarding becomes a hazard

There’s something to be said for “stuff”: our possessions help us to feel safe, fulfill a need and remind us of happy memories and people we love. However, taken to the extreme, pack rat tendencies can turn into a serious health and safety risk.

Hoarding may be more common than we think. Experts believe 1-5 per cent of the population could be affected — that’s as many as one million Canadians and 15 million Americans. No one knows the true scope of the problem because it’s difficult to define the issue and many cases aren’t reported. There isn’t a magic line between clutter and hoarding — experts say it’s more like a continuum between “harmless pack rats” and “extreme hoarders”.

What is hoarding?

For now, there isn’t a universally-accepted definition for “compulsive hoarding” or “hoarding disorder”, but most experts agree problem hoarding involves:

Acquiring and keeping too many items. Hoarders often buy things they don’t need and can’t afford, or collect trash and free items.

Not being able to discard or part with items. Getting rid of things is difficult and distressing. Some hoarders can’t even recycle junk mail or throw out gum wrappers.

Not being able to organize or manage possessions. There’s too much stuff to deal with so it doesn’t get put away or organized.

The clutter causes distress and impairs people’s daily lives, like interfering with living spaces or daily activities.

While many people struggle with “stuff” to some degree, hoarders aren’t able to change their habits without outside intervention. Some hoarders don’t see their habits as being a problem, while others are deeply ashamed of their homes.

The hazards of hoarding

While most people won’t be killed by clutter, hoarding poses some serious risks including:

Falling. Not only can people trip and fall over the clutter, it can topple and fall on them. These injuries can lead to disability and loss of independence, especially for older adults.

Fire hazards. Those collections of combustible materials turn homes into firetraps. When disaster does strike, it’s difficult for occupants to get out or for rescue personnel to get in.

Dangerous living conditions. Proper cleaning and maintenance becomes impossible. For instance, a leaky roof can lead to toxic mold, and the weight of extra stuff can cause structural damage.

Infestations. Insects, rats and other vermin love to eat rotting food and garbage and hide in all those nooks and crannies. Urine, fecal matter, dander and decay can build up and become airborne.

Animal hoarding also impacts the health of pets. It’s not possible to care for dozens or hundreds of animals, and many succumb to neglect or disease.

Damage to relationships. Shame and embarrassment keep many people from normal social activities like hosting a family dinner or inviting friends over. Many people withdraw due to shame or embarrassment.

Who is at risk?

Hoarding behaviour can start as early as adolescence and generally gets worse over time. It can become a serious problem by middle age, and experts warn seniors may be especially at risk.

Doctors aren’t quite sure what prompts hoarding, but many believe there is a physical or psychological cause. There isn’t a wide body of research on hoarding, but some studies associate it with mental illnesses like dementia and anxiety disorders. Some experts believe hoarding is a symptom or sub-type of obsessive compulsive disorder (OCD), while other feel it’s a separate entity. In fact, doctors are debating whether “hoarding disorder” should be added to the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

As reported by Time.com, a recent study found that brain activity in hoarders differs from people who don’t hoard and from people who suffer from OCD. When asked to make decisions about throwing out their own stuff, brain scans showed unusually high levels of activity in the part of the brain responsible for decision making. Another part of the brain responsible for the body’s physical state was also activated — perhaps signally negative emotions like shame or disgust.

When asked to get rid of other people’s stuff, hoarders weren’t so stressed — that same area showed an unusually low amount of activity. Both results suggest that hoarders place too much importance on their stuff, and getting rid of it is a lengthy and emotional decision. Participants who suffered from OCD didn’t exhibit the same patterns.

While hoarding affects people from all social and economic backgrounds, there could be a link to emotional trauma like divorce, the death of loved one, losing everything in a disaster or living through economic hardship.

Researchers do know there is often a family connection. Some studies have found that people who hoard have a family member who hoards — suggesting there is a possible genetic link or the lifestyle is learned.

What else paves the way for hoarding? Believe it or not, perfectionism plays a big role. People can’t decide whether to get rid of something because they’re afraid of making the wrong choice. It’s especially hard to part with items that remind us of people we have lost — a fact which may also put older adults at increased risk.

The warning signs

So how much is too much ? Experts warn to watch for these signs of hoarding:

– When the person sees something they want, they’re compelled to have it.

– The person finds it hard to get rid of things and is overly attached to (or protective of) their stuff. “I may need it later” is often the reason.

– Organizing stuff is difficult, and it’s hard to find things when you want them.

– It’s hard to move around safely because of the clutter, like piles on the floor and in hallways.

– Rooms, spaces and furniture can’t be used for their intended purposes without having to move things around. The tops of furniture become storage solutions.

– Daily activities are affected by clutter, like having to do the dishes in the bathtub or not being able to use the fridge. Hoarders also procrastinate and find it hard to make decisions.

– The condition of the home upsets the owner or their friends, family and neighbours.

How to help hoarders

Think a good cleaning is the answer? Experts warn clearing the clutter won’t treat the underlying causes of hoarding, and forcing a drastic change can cause more distress. If you know someone who is affected, here are some ways to help:

Learn more about the issue. Many people mistakenly attribute hoarding to greed or laziness, not a mental health or behavioural issue. When you understand the causes and the risks, you’ll be in a better position to help.

Empathize, not criticize. Criticism and judgment are often met with arguments and resistance. Experts recommend trying to see things from the hoarders’ point of view in order to help them see the need for change. Try to respect their autonomy and opinion rather than taking over.

Encourage them to seek help. You can’t fight their battles for them: it’s imperative that people want to change. Encourage hoarders to take steps like joining a support group or talking to their doctor.

Bring in an expert. When they’re ready for help, it may take an expert and some special equipment to tackle the job safely. There are many businesses that specialize in hoarding and combine an “extreme cleaning” service with support and coaching. Costs can run $45-$75 an hour, but some cities offer subsidies for at-risk people who have a low income.

Find support for yourself too. Hoarding doesn’t just impact homeowners. There are support groups and services out there for caregivers and children of hoarders as well. These services can provide valuable information and coping strategies in addition to an understanding ear.