Hoarding and homelessness

Hoarding and homelessness are inextricably linked. According to a video made by Homeless and Housing Resource Center for homeless advocates, people who hoard are more likely to become unhoused. And unhoused people are more likely to hoard, studies show.

Hoarding is a major problem in permanent supportive housing for people experiencing homelessness. In fact, where I live, Fusion Studios in Denver, the building is infested with bed bugs, roaches, and rodents. Management sprays regularly for the roaches, uses heat treatment on the bed bugs, and sets traps for mice, and I have not seen any type of bug in my room in well over a year. However, other rooms have them crawling the walls. And the mice are everywhere. I know of no tenant that has not experienced mice in their room. They have proven impossible to get rid of. A couple of days ago, my neighbor caught three on one sticky trap. I have gone almost a week without catching one and a few nights without hearing them scratching. The scratching noise is like something out of a horror movie as far as I’m concerned. Try to sleep when you know mice are in your room.

The reason we have a pest problem is because many people accumulate items in their rooms that they pick out of the trash. Others have not taken their trash out in a month or more. Rotten food accumulates, attracting vermin.

Before throwing stones, know that many people who live here are physically disabled and need help with household chores. Such services are provided to some residents. But many don’t want anyone to come into their room and decline such help.

Why people become hoarders

The video, which was funded by the Substance Abuse and Mental Health Services Administration, discusses solutions for people who hoard. People generally hoard for a few different reasons. Some simply don’t believe in throwing anything away for the good of the environment. Others believe all items have a use and value. Still others worry that if they throw something away, memories will be thrown away with it.

Hoarding is the excessive accumulation of personal possessions, according to Astrea Greig, a panelist in the video. The difficulty of discarding items causes problems in their daily lives, she explains. Perhaps they can’t move about their living space due to piles of clutter. They may be unable to reach critical areas of their home such as a sink, shower, stove, or bed. This also can create pest and fire hazards. “It compromises the use of a person’s living area,” Greig said, adding some rooms may be so cluttered they cannot be used.

Sometimes people accumulate and collect food or waste, Greig said. “It compounds and compounds and adds more unsanitariness to a person’s living situation.”

People who hoard often don’t see the seriousness of it, Greig explained. Others hold immense shame for hoarding. As a result, they refuse to engage with treatment or help resolving the hoarding, Greig said.

What’s hoarding disorder and what isn’t

Hoarding disorder affects 1.5 to 5% of population, Greig said. She said the disorder occurs across genders and that it generally begins in adolescence. It’s more common among the elderly, she explained, who may no longer work and spend more time at home. Hoarding also can occur after a major life stressor or traumatic event, Greig explained.

Some people have physical disabilities that prevent them from keeping a clean house. This is not considered hoarding disorder, Greig said. Hoarding causes significant distress. It may impair social functioning, work performance (Greig said hoarders are more likely to call in sick) and difficulty maintaining a safe environment for themselves or others. People diagnosed with depression don’t necessarily have hoarding disorder, she said.

Usually, the items that people have trouble discarding don’t have much actual value, Greig said. But they won’t throw them away due to a perceived need to not discard the items.

Some people hoard animals. We had a resident at Fusion who began collecting Guinea pigs from a nearby pet store. He amassed several of them and their pen, which was cordoned off with hay, took up most of the studio unit. Staff helped him get rid of the animals and he moved.

Problems hoarders experience

Hoarders experiencing homelessness encounter numerous problems. First, they sometimes get kicked out of shelters due to having too many items. Many shelters have no or inadequate storage for guests, so bags of belongings end up blocking pathways at the shelters. Extra belongings and shopping carts can also attract police if they are blocking public right of way at an encampment.

Sometimes hoarding can damage personal relationships with family or friends of the hoarder. People may shy away from visiting the hoarder or become frustrated with the situation. It is important not to judge the hoarder or say things like, “Why can’t you just clean up this mess?” Remember that hoarding disorder is a mental illness and there are reasons the hoarder has difficulty throwing things away.

For staff members who work in homeless housing projects, it can be challenging getting hoarders to pick up their rooms. Sometimes a total cleanout of the room is required, according to the video, and all items are discarded. It’s important to acknowledge to the hoarder that this likely will be upsetting but that it is needed for their health and safety, Greig said. Before the cleanout occurs, staff should ask the tenant if there is anything they absolutely need to keep, Greig explained. Have them re-evaluate what items are valuable and what can be discarded, she advised.

Taylor Doan, a clinical social worker in Boston who also was on the panel, said advocates should praise a hoarder for every improvement made, even if it’s only clearing one burner on the stove. She said conversations about hoarding can be very uncomfortable. When helping clean someone’s space, advocates should ask permission to throw things away. They can ask the person how long they have had certain possessions and why they are special. She said it’s important not to violate a hoarder’s boundaries as cleanups can be very invasive.

It can take several visits to get an apartment in better condition. “It’s going to take a long time but (hoarding) can be addressed and it can be changed,” Doan said.

Sometimes residents face eviction because of their hoarding. People with hoarding disorder can request reasonable accommodation with a doctor’s note about their diagnosis, said Miriam Bayer, another of the panelists in the video. “Sanitation can sometimes be subjective.”

Starting fresh

The pests were allowed to proliferate at Fusion under previous management. We spent several years at Fusion only having room inspections annually. Now they are monthly. Mousetraps are always available from maintenance and people can check out cleaning supplies with their IDs. These measures have helped with the rodent problem. Unfortunately, they have by no means been eliminated.

I know of two residents of Fusion who were told by management that they are hoarders who were moved to a much nicer, newer building. While this may sound strange, starting fresh in a new place can help reset hoarding habits. With proper counseling, there’s a chance the hoarder won’t resume the activity in the new place.

Not all hoarders experience homelessness. I have a cousin who is a hoarder. She came from a family who lived comfortably. Her mother, my aunt was one of the cleanest, most organized people I know.

Treating hoarding disorder

“The main treatment for hoarding disorder is cognitive behavioral therapy, or CBT, a skills-based approach to therapy,” according to Mayo Clinic. “You learn how to better manage beliefs and behaviors that are linked to keeping the clutter. Your provider also may prescribe medicines, especially if you have anxiety or depression along with hoarding disorder.”

Mayo Clinic’s advice to hoarders includes:

“Follow your treatment plan. It's hard work, and it's common to have some setbacks over time. But treatment can help you feel better about yourself, improve your desire to change, and reduce your hoarding. Have a daily schedule to work on reducing your clutter. Do this during times of the day when you have the most energy.

“Accept assistance. Local resources, professional organizers and loved ones can work with you to make decisions about how best to organize and unclutter your home and to stay safe and healthy. It may take time to get back to a safe home environment. Help is often needed to stay organized around the home.

“Reach out to others. Hoarding can lead to isolation and loneliness, which in turn can lead to more hoarding. If you don't want visitors in your house, try to get out to visit friends and family. Joining a support group for people with hoarding disorder can let you know that you are not alone. These groups can help you learn about your behavior and available resources.

“Try to keep yourself clean and neat. If you have possessions piled in your tub or shower, resolve to move them so that you can bathe or shower.

“Make sure you're getting proper nutrition. If you can't use your stove or reach your refrigerator, you may not be eating properly. Try to clear those areas so that you can prepare healthy meals.

“Look out for yourself. Remind yourself that you don't have to live in chaos and distress — that you deserve better. Focus on your goals and what you can gain by reducing clutter in your home.

“Take small steps. With a professional's help, you can tackle one area at a time. Small and consistent wins like this can lead to big wins.

“Do what's best for your pets. If the number of pets you have has grown beyond your ability to care for them properly, remind yourself that they deserve to live healthy and happy lives. That's not possible if you can't provide them with proper nutrition, clean living conditions, and veterinary care.”