The 5 Stages of Hoarding: What are They?
Recognising the
signs of Hoarding, as with any mental health condition, is the first step to
getting the appropriate care. The sooner you identify the symptoms, the
sooner the recovery can begin.
Hoarding is a
mental health disorder. Despite what you
might see on reality TV shows. It
affects between 2.5
% – 6 % of the United Kingdom.
People have very
different ideas about what it means to have a cluttered home. To overcome the problems associated with over-and
under-reporting of hoarding symptoms, a universal clutter image rating (CIR)
was developed. This was based off a study was completed by Frost
RO, Steketee G, Tolin DF, Renaud S. In
short –The
CIR’s picture method make it easier for measuring the clutter dimension of
compulsive hoarding.
If left untreated, there
can be many negative consequences with regards to hoarding , including causing relationship
problems, work and social activities disruptions. There are also safety hazards in the home
like tripping, fires, harmful bacteria, and potential rodent infestations.
Listed and defined below
are the 5 stages of hoarding, so you can protect your loved ones and know if
it’s time to intervene.
Stage 1. Clutter, but no concern
This is the lowest
stage on the hoarding scale, it generally means a person isn’t at risk of being
a hoarder and doesn’t require action. If someone fits into this category, their
home is a bit disorganised, but it is safe, and sanitary. The space will have
the following conditions:
· All stairways, doors, and windows are accessible
· Sufficient ventilation
· An appropriate number of pets live in the environment
· Fire and carbon monoxide detectors are installed
· No unpleasant odours
Clutter may be present in small amounts, but it’s temporary and recognised by the
homeowner. The person in question also takes care to maintain a regular and
consistent housekeeping routine.
Stage 2. Deteriorating hygiene, possible hoarder
Concerns should be
raised if someone exhibits symptoms from the second stage on the hoarding scale. However, this may not inevitably suggest a
hoarding diagnosis. A person who fits into this category might need
professional cleaners to organise their space, which will have the following:
· One important exit blocked with clutter
· Pet faeces and hair in parts of the house
· Problems with some of the electric and plumbing systems
· Overflowing garbage points
· Dirty dishes, laundry, and mould growing in different spaces
The person will, at
this stage, have an inconsistent housekeeping routine, but likely an awareness
that their home is deteriorating in hygiene.
Stage 3. Extreme disorganisation, likely disorder
This is the threshold
between a messy, cluttered environment, and one that may be a hoarding
environment. The space will be noticeably disorganised and overwhelming, and
the individual’s behaviour may be changing. Physical signs in the house
include:
· Insect infestations from ants, cockroaches, bed bugs, and lice
· Piles of objects obstructing key living areas
· Multiple broken appliances
· Unwiped spills and breaks left for days
· One room is not being used for its intended purpose (e.g., the bathroom used for storage)
Both medical and
cleaning professionals should be called if you worry that someone has reached
stage 3. When contacting them, specify the details of the person’s living
conditions and behaviour. For example, if they have become more secluded,
refuse to have the camera on during video calls, or struggle to throw items
away that clearly have little or no value.
Stage 4. Excessive clutter & behaviour, contact professionals
Someone suffering
from Stage 4 symptoms is deemed highly likely to have a hoarding disorder.
Housing agencies, protective services, elderly services (if necessary, and
animal control may need to be contacted to restore the place of residence,
which will contain:
· Structural damage in the home (e.g., water damage, broken doors, plumbing)
· An excessive number of pets and pet waste
· Clutter preventing entrance to stairs, rooms, and exits
· Expired and rotting food
· Odours and backup in sewage points
A coordinated team
of cleaners will be needed in this circumstance, alongside mental health
experts and social workers. The homeowner will likely show anxiety about
needing items in the future or become distressed when others touch or suggest
removing their belongings.
Stage 5. Severe unsanitary conditions, hoarding diagnosis
This is the highest
stage on the scale indicates a severe hoarding
condition. The affected individual may even be going through legal proceedings
like divorce, custody, or eviction because of the state of their home. The
housing environment will require intervention from a number of professionals as
well as family and friends, who can easily identify:
· Extreme indoor clutter making key living spaces unusable
· No ventilation
· Irreparable damage to the home’s structure
· Disconnected water and/or electrical services
· Pervasive mould and mildew
· Animal health is at risk, and animals are a danger to humans
At stage 5, anyone entering the home will require full personal protective equipment (PPE) such as face masks, safety goggles, gloves, hand sanitiser, and a first aid kit. The cleaning process will also require specialised tools and chemicals to safely restore liveable conditions and remove harmful bacteria.
Coming to terms with the possibility of a loved one being a hoarder is not easy. However, acknowledging when someone may need help can have a hugely positive impact on their journey ahead. Once you’ve accurately determined which stage they are in, you can move forward with processes like arranging a professional clean-up team to make their home a sanitary, comfortable space again.
If you would like a
copy of the Clutter
Rating Pictures you can download them.
If you would like
any help on hoarding, I have listed some relevant links below: