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Uncovering the dangers of hoarding disorder

Winslow Townson for The Boston Globe

Eileen Dacey, a social worker who runs the North Shore Elder Services’ Center for Hoarding and Cluttering in Danvers, meets with 10 to 20 clients every week

By David Rattigan Globe Correspondent 

The fire last February that killed 86-year-old Beverly resident Renee Mary – known as “The Duck Lady” because she would stop traffic to shepherd birds across busy Hale Street at Endicott College – put the spotlight on the local hoarding disorder issue among the elderly. But what they found when they came to battle the blaze was nothing new to the city’s firefighters.

In 32 years, Fire Chief Paul Cotter recalled two other calls when firefighters had difficulty entering because doors were obstructed by clutter. Many other times, they witnessed similar conditions during a wellness check or a medical call.

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“There’s so much involved with this,” Cotter said, noting that too much clutter can push flammable material closer to stoves and ovens, and those with the hoarding disorder “may not pay attention to their smoke detectors or alarms.”

The practice is not unique to seniors, said Eileen Dacey, a social worker who runs the North Shore Elder Services’ Center for Hoarding and Cluttering in Danvers. In any given week, Dacey meets with 10 to 20 clients in individual or group counseling, crisis management (in the case of evictions), or housing inspections.

However, elder cases are the most frequent. For one thing, the elderly have more contact with service providers such as those from Meals on Wheels or emergency medical personnel, who are required to report hoarding behavior to a protective services agency. Anecdotally, seniors with the hoarding disorder often deal with losses such as the deaths of friends or even retirement that can be emotional triggers for the behavior, said Dacey. In addition, it’s simply a matter of fact a person in their 60s or older has had more time to accumulate clutter.

“They’re all individuals, with unique needs,” Dacey said.

After hearing about Mary’s death in Beverly, Joe Sabella, who lives in Manchester-by-the-Sea, began researching the subject, including attending pilot classes for families of those with the disorder. He shared his findings with his old friend, state Representative Ted Speliotis, whose district includes Danvers, Middleton, and parts of Peabody.

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“It was an eye opener for me,” said Sabella, who said he has no personal connection to the disorder and had considered the behavior an eccentricity. “There’s a whole psychological side to it.”

Though there is a reporting system used by those who enter a senior’s home for other reasons, Speliotis said any legislative action would have to balance public safety concerns with the individual’s rights as a citizen.

“Right back to the Constitution, we’ve treated the home as a person’s castle, and that’s a very important protection,” Speliotis said. “If we could find a balance, I’d welcome it, because it is a public safety concern.”

Many with hoarding disorder have associated problems such as indecisiveness, perfectionism, procrastination, disorganization, and distractibility, according to the American Psychiatric Association. Dacey said simply cleaning out a house creates a lot of anxiety, and may trigger a recurrence of the behavior.

The approach Dacey and others take is a nonjudgmental “harm reduction” approach to making the home safe by clearing pathways and access to doors, windows, and smoke alarms in a gradual way.

An example documented by the North Shore Elder Services’ Center for Hoarding and Cluttering.

Last spring, she and 18 volunteers worked on the state’s first “Safety Day.” A client in Danvers was coming home from the hospital after surgery and needed to move safely inside the house. So volunteers bagged and boxed items to clear access to doorways, windows, smoke detectors, and appliances.

The television show “Hoarders,” which debuted in 2009 and continues in various forms on A&E and Lifetime, increased public awareness. But Ned Kittredge, who recently retired from Beverly-based Associated Home Care, which does heavy chore work and cleanups for seniors among its services, said the sudden and quick cleanup of the home is not the way to go.

“They’re making TV . . . The last thing I really want is five family members showing up to help out,” said Kittredge, referring to the additional psychological stress on those with the disorder.

Nationally, estimates of how much of the population has hoarding disorder runs between 2 percent and 6 percent, but Dacey noted that many professionals think that figure is low.

“Most people in hoarding situations don’t self-report,” she said. “They’re discovered.”

When problems pile up

 Hoarding disorder occurs in an estimated 2 percent to 6 percent of the US population.

 Some research shows it is more common in males than females. It is also more common among older adults: three times as many adults 55 to 94 years are hoarders compared to adults 34 to 44 years old.

 Specific symptoms for a hoarding diagnosis include: Lasting problems with throwing out or giving away possessions, regardless of their actual value. Items fill, block, and clutter living spaces so they cannot be used, or use is hampered by the large amount of items.

 Many with hoarding disorder also have associated problems such as indecisiveness, perfectionism, procrastination, disorganization, and distractibility.

SOURCE: American Psychiatric Association

For more information on local help, go to nselder.org/north-shore-center-for-hoarding-decluttering. For a list of statewide resources. go to: www.masshousing.com/hoarding or call 800-243-4636.


David Rattigan can be reached at drattigan.globe@gmail.com.