Cambridge reaches out to those who can't stop hoarding

City reaching out to those who hoard

City Councilor Henrietta Davis calls the injuries and evictions that can sometimes result from hoarding ''terribly tragic,'' and has asked for a task force of Cambridge agencies to work on the problem. (Pat Greenhouse/Globe Staff)

Their homes overflow with stacks of newspapers, piles of clothes, or even toilet paper tubes. Hoarders - people who accumulate objects to the point that it interferes with their ability to carry out daily activities - are sometimes trivialized as best suited for assistance from Oprah or the Container Store. But an estimated 15 million Americans suffer from the condition, and it is a problem that Cambridge's Council on Aging and the City Council's Health and Environment Committee have been working to address.

"We all probably hoard to a certain degree," said Susan Pacheco, the Council on Aging's director of client services, who takes in and screens referrals to provide assistance for hoarders. "But it really comes down to the point of whether an individual can really look at an item and say, 'Do I have a specific purpose for this?' and 'What sort of attachment do I have to that thing?' and be able to rationalize."

City Councilor Henrietta Davis called the injuries and evictions that can sometimes result from hoarding "terribly tragic" and submitted a policy order to the City Council in July calling on City Manager Robert Healy to set up a task force to coordinate services among providers involved, including the police, Fire Department, Housing Authority, and Department of Public Works. A public meeting Davis chaired last month served as another forum in which to discuss such challenges as resource and funding shortages.

The problem is also of particular concern to the Council on Aging: Seniors who lose a spouse may find it difficult to part with items of sentimental value; older residents also often need to move into apartments from large family homes and, during the transition, struggle to fit their belongings into the smaller space.

Hoarders can have their living areas so cluttered that "they're at the point that they've either received a notice from housing that they're not going to pass inspection or something else happens where fire or first responders have come into the unit," and find issues that need to be addressed, Pacheco said.

Accumulated items often represent some part of the hoarder's identity, said Standolyn Robertson, president of the National Association of Professional Organizers and a Waltham-based professional organizer who works with people who exhibit hoarding behavior.

"If you meet someone who's a hoarder, you're going to find someone who is truly a thoughtful, kind, loving person that just doesn't have the same vehicles maybe someone else has for letting stuff go," she said. "They'll be collecting something with such good intentions. 'I was in the Peace Corps, and they could really use these T-shirts.' But for some reason the T-shirts never really get there."

"The most effective mental health treatment is cognitive behavioral therapy for compulsive hoarding," said Christiana Bratiotis, project director for a compulsive hoarding research project at Boston University's School of Social Work. The school hosts a 26-week outpatient program designed by a BU professor, Gail Steketee, and Randy Frost of Smith College.

The treatment regimen includes simply practicing throwing things away, as well as sorting through piles of objects. One exercise involves visiting the dollar store, a popular destination for hoarders because of the plethora of inexpensive merchandise, and picking up an object but not buying it. In a presentation to the BU School of Social Work's alumni association last year, Steketee noted that even this act is "very, very hard to do.

"It's like someone trying to quit smoking and then having a cigarette put in their hand and lighting the match," she said.

While hoarding is often thought to be present in individuals with obsessive compulsive disorder, Steketee's research has shown that it is most closely linked to depression. One study found that 60 percent of hoarders meet criteria for major depressive disorder.

"It's very slow, hard, and exhausting work," going through items accumulated in hoarders' homes, noted Robertson, the professional organizer from Waltham. "They're not using their rooms for their intended purposes - for example, they're not sleeping in their bedrooms," because these rooms are so full of clutter.

"They're the recyclers who don't have a good way of getting rid of stuff," she said. "Everything could be used for an art project, or it's that love of information. There's some good information in that newspaper, and they can't just throw it away."

Cambridge's Council on Aging receives $5,000 a year to work on helping diagnosed hoarders clear out their accumulated belongings and thereby avoid being evicted from their homes. But the funds dry up quickly; a grant awarded in June 2007 ran out just five months later after 20 seniors were helped.

A major challenge for helping seniors who hoard is that many simply go unidentified, especially if they are living on their own and are not aware that they may have a problem.

To address this lack of awareness, Pacheco applied to the state's Executive Office of Elder Affairs for an additional $2,500 to host a series of community meetings during which Bratiotis gave presentations on hoarding.