How to help a hoarder: a plan made with them

Hoarding is more than owning a lot or keeping an untidy home. The criteria clinicians use for hoarding disorder describe three things together:

• persistent difficulty getting rid of possessions;
• clutter that stops rooms being used for what they are for, such as a kitchen where no one can cook or a bed no one can sleep in;
• distress, or problems in daily life, because of it.

The NHS says hoarding can get in the way of cooking, washing, moving around the home and getting out safely. The home does not have to be dirty: the criteria are about clutter and letting go of things, not dirt.

Things family and friends may notice:

• rooms, seats or a bed that can no longer be used;
• narrow paths between piles, or blocked hallways and doors;
• distress at the idea of throwing things away, or keeping things “just in case”;
• not letting visitors, repair workers or the landlord in;
• repairs left undone because no one can reach the boiler, pipes or wiring.

Only a clinician can diagnose hoarding disorder. Our clutter scale rates how full each room is with pictures, which can be an easier way to talk about it than words.

Mind’s guidance on helping someone who hoards recommends respecting the person’s choices and focusing on their safety and wellbeing, and advises against surprise or unwanted clear-ups. In practice:

• Start with what they would like to change. Ask “What would you like to be able to do at home that you can’t now?” or “Would it help to have a clear path to the front door?” rather than “This all needs to go.”
• Talk about safety and how they are: getting out in a fire, not falling, having heating and a working kitchen. Leave the amount of stuff out of it.
• Use their words for their things. Avoid “rubbish”, “junk” and “hoarder”.
• Offer something specific, such as “I can come on Saturday for an hour and carry bags to the car”, rather than a general offer to “sort it out”.
• Accept a no, and ask again another time. In England and Wales adults are presumed able to make their own decisions, including ones others think unwise (Mental Capacity Act 2005).
• Suggest support, not only sorting: a GP, the HoardingUK helpline or a support group.

• Do not clear the home while they are out, away or in hospital. Mind advises against surprise or unwanted clear-ups.
• Do not throw things away without their agreement, even things that look like rubbish to you.
• Do not decide for them because the home is cluttered. Capacity is about a particular decision at a particular time, and a cluttered home does not on its own show that someone lacks it (Mental Capacity Act 2005, England and Wales). If you are worried they cannot understand or weigh up decisions about their home, raise it with their GP or adult social care.
• Do not expect a clear-out to fix it. Clearing possessions is not the treatment the NHS describes: it names cognitive behavioural therapy as the main treatment, starting with a GP.
• Do not use threats or ultimatums to get agreement.
• Do not share photos of the home, or talk about it to others, without their permission.

In UK forum threads, people who live with or look after someone who hoards ask how much of their time they are expected to keep giving, how to agree what goes, and what to do when a cleared home fills again. Those are fair questions, and the answer starts with looking after yourself.

• Decide how much you can give, and say so. Keep time for things that are not about the home.
• Agree the shared spaces. If you share the home, you have a say in the shared parts: a clear way out, a usable kitchen and a working bathroom. Decisions about their own possessions stay with them.
• Get support for yourself. The HoardingUK helpline supports relatives as well as the person who hoards, and HoardingUK runs groups, including online support for family and friends. If you need to talk to someone, Samaritans are on 116 123, free, at any time.
• If you are worried about their safety and they refuse help, you can raise a concern: in England with the council’s adult social care team, in Wales with local social services, in Scotland with the council’s adult protection team, and in Northern Ireland with the Adult Protection Gateway Service of the local Health and Social Care Trust. A concern does not automatically lead to action; self-neglect is looked at case by case. Find the right council by postcode.

If this is your own home, the tool above makes a plan worded for you: choose “It is my own home”. You decide what happens to your things.

Hoarding disorder is a recognised health condition, listed by the World Health Organization in ICD-11 (6B24), and there is treatment for it.

• Start with a GP. The NHS names cognitive behavioural therapy (CBT) as the main treatment for hoarding disorder. If it is hard to explain, HoardingUK’s Ice-Breaker Form lets you mark the areas affected and your concerns, to take to the appointment.
• Call the HoardingUK helpline on 020 3239 1600 or email info@hoardinguk.org. It is confidential: you register and are matched with a support worker for one-to-one sessions. It is an ordinary London number, not freephone, and not a crisis line.
• Start small. Mind’s page on helping yourself with hoarding suggests small steps. One shelf, one chair or one bag is a real start.
• Set your own rules if someone helps: nothing goes without your say, and one area at a time.

With the person’s agreement, family and friends can do much of the work. These points cover safety, and the rules on getting rid of waste.

Safety while you work

• Clear a way out first, and keep it clear while you work.
• Take piles down from the top. Do not pull items from the bottom of a stack.
• Wear sturdy shoes and gloves, and keep windows open where you can.
• Needles and syringes: do not touch them. Where the council has a page on needles, our postcode search links to it. If someone is pricked by a needle, get urgent medical advice.
• Rats, mice or insects: call the council’s pest control service or a private pest controller, and ask what needs clearing before they come. Some councils charge.
• Human or animal waste, rotten food or mould: clearing these can expose an untrained person to needle injuries, splashes and reactions between cleaning chemicals. This is the point to bring in a specialist firm.
• Cleaning products: never mix them. The Health and Safety Executive warns that bleach (hypochlorite) can release chlorine gas when mixed with acids or acidic fluids such as urine.

Getting things out of the home

• Council bulky waste collection for furniture and large items (check the council's charges). Hazardous household waste, such as chemicals, paint and gas bottles, has its own council service. Both are in our postcode search.
• Charity shops and furniture charities: ask what they accept before you take things.
• Skips: skip firms do not take everything, so ask what they will not accept before you fill one.
• Ordinary bin collections may not take extra bags. Plan how waste will leave the home before you start.
• Paying someone to take it away: check they are a registered waste carrier on the Environment Agency register (England; Wales, Scotland and Northern Ireland have their own registers). In England and Wales, householders must take reasonable steps to give household waste only to someone authorised to take it, and in England a fixed penalty of up to £600 can be issued for breaking that duty.
• Papers: keep letters, bills and documents in their own box to go through later. Some may be important.

Cleaning once it is clear

• Work one room at a time, from the top down: shelves and surfaces first, floors last.
• Check what the clutter was hiding: damp, mould, pests, damaged floors, and appliances or vents that were blocked. Have gas appliances checked before they are used again.