Inquire about the reason for saving items. Individuals who hoard often save items due to attaching a sentimental value, instrumentality (they think they can use it somehow or someday), and intrinsic value (they think it’s pretty or interesting in some way). [1] X Research source Ask questions about the reason why the individual obtains or holds on to certain items.
Be cognizant that if the person does have a Hoarding Disorder (HD), the process of recovery could take time.
The best form of help for a Hoarding Disorder (HD) would be therapy with a psychologist, Marriage and Family Therapist (MFT), or a psychiatrist. Remember that the person who hoards may not want to get treatment. Do not force this idea on them.
Online help and support groups have been suggested as helpful for recovery from hoarding. [5] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Explore medication options. Several medications have been indicated in the treatment of hoarding including Paxil. [6] X Research source Consult a psychiatrist for additional information or to discuss psychotropic options.
First and foremost, hoarding can cause health and safety risks. Explain to that hoarding is dangerous because: it may prevent them from being able to escape in an emergency, does not adhere to fire codes, and can lead to mold and other harmful buildup in the home. It can also cause complications in activities of daily living (ADLs) such as walking, moving around, finding objects, eating, sleeping, and using the sink or bathroom. [10] X Research source Hoarding can lead to social isolation, disruption of relationships, legal and financial issues, debt, and property damage. [11] X Research source Some issues that may coincide with hoarding behaviors include negative and unhelpful thoughts such as perfectionism and fear of regretting removal of information or objects, over-attachment to material items, reduced attention abilities, and lowered capacity to make decisions. [12] X Research source
Explain your concerns and set boundaries. Explain that you will not continue to live or be in the house if it is unsafe or unsanitary (if this is feasible).
Assess the level of openness to your assistance. You could say something like, “I know you’ve been concerned about your hoarding and I am also. I am here to help if you want it. What do you think?” If the individual responds negatively and says something like, “Absolutely not, I don’t want you forcing me to throw away my prized possessions,” you may want to back off for a while. If the individual says something like, “I might be open to that,” give them some space to decide if they are willing to let you help. You can revisit the conversation at a later time.
Write down the specific goals you have developed with the person needing help. This list might look like: reduce clutter, be able to move through the living room with ease, stop buying new items, and organize the attic.
Identify specific criteria for keeping and discarding items. Ask the person who hoards what criteria they would like to create for getting rid of items versus keeping them. You could say something like, “Let’s see if we can make a plan that will help us organize our time. Would you be open to making a list of reasons to keep items? What are the types of items that you absolutely need to keep? What are the types of items that you can let go?” Make sure they are still open to receiving help, and if they are receptive to this idea you can move forward with your plan together. Make a list of the criteria to keep or discard items. This might look like - Keep if the item is needed for survival or daily life, or if it is a family heirloom. Toss/sell/donate if item is not currently being used or has not been used in the last six months. Categorize and organize wanted items, as well as unwanted ones. Talk about storage locations and systems of discarding items. Select interim locations during sorting. Sort items into categories such as: trash, recycle, donate, or sell. [17] X Research source
Do not simply choose which items to trash, have the person with the hoarding problem make their own decisions based on the criteria you developed together. If they are unsure, help them refer back to the list of reasons to keep or discard an item. You can ask questions like, “Is this item necessary to daily life, has it been used in the last six months, or is it a family heirloom?”
Start with easy items first then move to harder ones. Ask the individual where will be the easiest place to start; the place that they feels will be easiest for them to deal with emotionally. Always ask permission first before touching any item that the individual is hoarding.
If you find that hiring help is out of your budget, you can attempt to get other friends or family members to assist you. Try asking by saying, “Sam needs our help with their hoarding, do you think you can spare a day or two to help clean the house and get rid of some of the items?”
Work with them to develop a hierarchy from easier to harder situations to deal with such as: driving by a shopping center, standing at the entrance of a store, walking through a shopping center/thrift store/mall, browsing a store, seeing an item you desire, physical contact with said item, and leaving the store without the object. Ask questions that may help to develop alternative thoughts about the usefulness or necessity of the objects they may want to obtain. For example, you can inquire by asking, “Do you have a specific use for this item? Can you survive without it? What are the pros and cons of having this object?” Assist in making rules for obtaining new items such as having a direct use for the item, needing the financial means to purchase the item, and requiring enough space to house the item.
Individuals with Hoarding Disorder may have brain abnormalities that result in difficulty identifying the emotional worth of an object, having normal emotional reactions and regulating emotions while making a decision (whether to buy, save, or throw out an object). [24] X Research source
