Hoarding Best Practices Guide

Best Practice Hoarding Guide Final   (link to full document)

Hoarding is a complex issue that affects people across age, socioeconomic, and racial lines. It is not only an issue that affects the individual, but also the family and community. Research has shown that while the onset of hoarding starts around age thirteen, the average person seeks treatment around age 50 (Bratiotis, Sorrentino & Steketee, 2011).
It has been the committees’ experience that many people who hoard choose not to seek treatment and only come to the attention of public agencies when they are considered older adults (60 and older in Massachusetts). The person who hoards is not seeking treatment, but rather has been discovered by a mandated reporter or neighbor often due to a fall, an incident such as a fire or odors emanating from their home. Once “discovered” the very private issue that they have fought so hard to hide quickly becomes public. The individual is thrown into a swirl of decisions and a multitude of people approaching them. This can lead to anxiety, frustration and fear causing many people who hoard to shut down and refuse help. Unfortunately this reaction often leads to more involvement from protective services, city officials and eventually the courts.
Without active participation from the person who hoards the courts often choose the option of a clean out of the apartment/house, charging the resident, landlord or putting a lien on the home. The individual might also be forced to leave their home and therefore become at risk of homelessness. While a clean out addresses the immediate public health issue of hoarding, the recidivism rate is near 100% for a person who hoards without any type of behavioral treatment (Bratiotis, 2011). Thus the cycle of acquiring and the failure to discard will begin again at some point, leaving the professionals that tried to help frustrated and their agencies financially drained.
It is the Hoarding Best Practice Committee’s hope that this document will provide new information to the ASAPs and other social agencies serving elders in the Commonwealth. Our aim is to offer our combined experience and expertise to the field as we all strive to work with elders on this very serious issue that affects their physical and emotional health and safety every day. This document is a collaboration of our experience and can be used as a guide to effectively address the hoarding behavior of elders living in our communities while at the same time respecting their dignity and self-worth.
We would like to thank everyone who helped us put together this handbook, with a special thank you to Greater Lynn Senior Services Hoarding Project and Merrimack Valley’s Safer Homes Program, for sharing their work documents with us and to Brenda Correia, Jonathan Fielding, Duamarius Stukes and Denise Bradley from the Executive Office of Elder Affairs for their guidance throughout the project.
Laurie Grant
Hoarding Best Practice Committee:
Chair, Laurie Grant, Greater Lynn Senior Services
Michele Martindale, Greater Lynn Senior Services
Deborah Schwendiman, Senior Care, Inc.
Dori Prescott, Senior Care, Inc.
Kim Flowers, Elder Service of Merrimack Valley
Kathleen Turner, Brookline Community Mental Health
Marnie McDonald, North Shore Elder Services