For those who have ever been to a home where a hoarder is living, it can be quite a shockingly dismaying experience. Hoarders are not collectors or people who tend to clutter but are classified as suffering from a DSM-V mental disorder. The American Psychiatric Unit definition includes the following characteristics: 1) difficulty discarding, 2) accumulation of stuff that prevents normal use of space, 3) distress or impairment and 4) behavior not due to some other medical or mental health condition. For example, the disorder is not classified as depression, but there can be symptoms of depression along with it. Under the federal Fair Housing Act, hoarding can also be classified as a disability and reasonable accommodations can be provided to prevent eviction and help the individual in the meantime.
On May 11, an insightful Philadelphia Bar Association CLE program titled “Hoarding Intervention and Response: Strategic Approach” was hosted by the Elder Law Committee and presented by Community Legal Services of Philadelphia’s David Wengert, MSW, Housing Unit, and Pamela Walz, supervising attorney, Aging and Disabilities Unit. Wengert and Walz are also both members of the Philadelphia Hoarding Task Force. Attendees learned just how complex the hoarding process can be. Hoarders engage in an expensive evaluation of everything that they wish to keep and the disorder can either be active or passive, like accumulating unopened mail and unpaid bills. Hoarders, unlike collectors who take pride in their collections, face feelings of shame, sadness, embarrassment and social isolation as a result of their behavior. Additionally, they can incur a great deal of financial debt. Hoarders do not necessarily live in squalor and there does not necessarily have to be food, waste or rodents in their “collection of stuff.”
There are additional misconceptions surrounding hoarders and the best methods of intervention and treatment. Most importantly, though, when assisting an individual who is a hoarder, it is important to engage with the them by building a rapport and focusing on a supportive environment.
There are two general processes involved in assistance – engagement and enforcement. Engagement is the supportive piece. With training and practice, most social workers seek to engage with the individual. When entering a hoarder’s home, a potentially shocking experience at first blush, try to find a piece of furniture to compliment, or remark that the kitchen is nice (if the kitchen does not present hoarding issues). It also is advisable to thank the person for allowing you to enter their home. The enforcement piece focuses on cleaning up, essentially focusing on the stuff. Philadelphia’s Licenses & Inspections department can order a cleanup, and there are various other organizations that seek to enforce or clean up the home. Enforcement without engagement does not appear to be the best possible solution to the problem. Focusing both on the individual and the cause of the trauma as well as a cleanup is encouraged.
When conducting an intervention, it is wise not to touch any of the items. Build trust and ask questions. Additionally, the basement or garage is not considered when conducting an intervention. The belief is that these areas are acceptable to accumulate belongings.
With 2-5 percent of the population potentially affected with this condition; it is important that attorneys understand the disorder and realize that there are many community and legal service mechanisms in place for assistance. Applying for a disability is important if the person would like to stay in the home, but it remains a complex situation for landlords, other renters and the individuals themselves. There are no easy answers, but understanding and compassion should be the focus.
Maureen M. Farrell (firstname.lastname@example.org), principal of the Law Offices of Maureen M. Farrell, is an associate
editor of the Philadelphia Bar Reporter.
This article originally appeared in Philadelphia Bar Reporter, January 2017.