I helped out my elderly neighbor for over fifteen years, but I never saw the inside of her house till a few months before she died. I knew she was a hoarder. She never identified herself as such, but there was plenty of evidence. One day she admitted to me she had a house full of stuff. “Mostly clothes,” she told me. She recognized that her living situation was not normal and she was always fearful that someone would report her. In fact, it had taken me about five years of building trust with her before she would even let me give her rides to doctor appointments or pick up something she needed at the grocery store. So it was a big deal for her to talk openly with me about how “messy” her home was. Like many older adults she dreaded the possibility of being forced out of her home. “I would just die if that happened,” she often declared.
Over the years I tried everything I could think of to help her improve her situation, but her attachment to her home and the hoard within made her refuse every option. All our conversations happened in the car as we ran errands or standing on her doorstep, because she would never let me in her house. Out of town relatives were unsuccessful at changing her mind and unwilling to become more involved. When her health began to seriously deteriorate, I knew my friend would reach a crisis point before long. Because she wouldn’t accept any kind of help, even an emergency alert system, I watched her slowly become less coherent and less mobile and knew I would soon be faced with a difficult decision.
One of the organizations I reached out to for help during this time was the Hoarding Connection of Cuyahoga County. The Hoarding Connection is actually a consortium of many local organizations. Its mission is to educate the community about hoarding and about the need for collaboration between mental health, public health and social service agencies to help those who hoard. The Hoarding Connection attempts to bring together prepared teams of responders who use a compassionate and effective approach to help individuals who hoard.
The practice of hoarding, or Hoarding Disorder, was officially classified as a mental illness in 2013 with its own set of specific symptoms. Clinical studies have shown that there are differences in the brains of people who hoard as opposed to those who don’t. For example, people who hoard have lost some control of their decision-making abilities. And they often become desensitized to the clutter around them, so they don’t notice it as a problem.
Many of us have seen programs on TV that show homes in horrific conditions and the dramatic stories of people being forced to clear out the massive mess. However, mental health experts insist that eliminating clutter in this rushed process, without giving the individual the time needed for treatment, will almost always result in failure.
Successful treatment usually means the involvement of a trained team of experts, the patient support of friends and family, and possibly years of slow progress. There may be a long period of counseling necessary before the person will even consider the possibility of getting rid of anything. In some cases, the goal is just to get an individual to reduce clutter to what is called Minimum Acceptable Standards. The living situation at this level is not ideal but it’s usually enough to allow someone to stay in their home safely.
Here at Hanson Services when a new home care case is started, we usually first make a visit to the potential client’s home to do a free “assessment.” An assessment is just a conversation where we gather information on personal preferences and what type of help the person will need. Once in a while, when we visit the home, it is apparent the person hoards. Because we cannot send a caregiver into a situation that may be a health hazard, we will help the person, or their family, find the help they need to address the situation. Such help might include a social worker, a professional organizer, or a cleaning company who works with persons who hoard. Often the Hoarding Connection is a great way to find all the services needed. In extreme cases Adult Protective Services(APS) may have to be involved. Once a situation is made manageable we do our best to help the client keep it that way. It’s often a lifelong struggle, but the challenge is made easier by keeping supports in place.
Even though my elderly friend would not accept any help, she did finally allow me to come into her home. As she had been warned by physicians, her cardiac issues had become so severe she could barely walk at that point and I convinced her to give me a key in case she couldn’t make it to the door. It was as cluttered and dirty as I feared. Her bed was a single, dingy mattress on the floor surrounded by bags and piles of clothes. It made me sad to think she had been living in such awful conditions for so long, but I had to remind myself that it was very much her insistent choice to do so.
It wasn’t long after that, with the agreement of out of town relatives, I notified APS about my friend. The day the social worker came, I met her at my friend’s house so I could help with the conversation. We found my friend half on and half off her mattress with her feet buried in the piles of clothes around the bed, unable to stand. EMTs came and got her up and took her to the hospital.
Just a few weeks later I said goodbye to my friend at a hospice facility. She was in a lovely, clean room, with soft music playing. Although she was unaware of her surroundings by then, it made me feel better to see her safe and comfortable. She slipped away peacefully leaving all her things behind as we do.
If you are caring for someone who hoards, please consider contacting the Hoarding Connection of Cuyahoga County for help. It’s not just a matter of making a home look better. Living amongst a hoard greatly increases health risks such as falling, obesity, and respiratory problems to name just a few. You can call for information and recommendations and proceed at a pace that works best for your situation. Go to www.hoardingconnectioncc.org to learn more or call 216-791-8000. If you aren’t in Cuyahoga County you may still contact them and they will assist you in finding help in your area.
Maybe your loved one isn’t a hoarder but does have quite a bit of clutter in their home that they can’t seem to manage or clear out. A professional organizer may be able to help in that case. They help a client establish goals for getting organized based on their individual needs. Then they work with the client to get things under control and teach organizing skills for the future. You can find a professional organizer through the National Association of Productivity and Organizing Professionals (NAPO) at www.napo.net In the Cleveland/Akron area check out Wholly Organized. www.wholly-organized.com
Although there are many challenges involved in helping someone get their home organized, it’s worth the effort. And there are professionals out there who can assist with the entire process. That effort can actually improve quality of life for a person who hoards. And it might even save their life.