A hoarder’s living room

A hoarder has difficulty in throwing away items. It does not matter if the items are worthless. He or she will still have difficulty letting go of them. Hoarding is long lasting and difficult to treat. Hoarding can hurt how someone feels. It can also damage their health and finances (Neziroglu, 2015).

In May 2013, mental health guidelines began listing hoarding as a separate disease from obsessive-compulsive disorder (American Psychiatric Association [APA], n.d.). Hoarding starts in childhood. It often does not go away and gets worse. Hoarding becomes more common as people age (APA, n.d.).

Hoarders most commonly save newspapers, old clothing, books, mail, notes, and pets (Day & McCarthy, 2016). The items continue to pile in the house until there is no more room. There may be no space left for cooking, sleeping, and bathing (Brown & Meszaros, 2007). Hoarders may forget to pay bills because of the clutter. Piled items may fall on them and seriously harm them (Frost, Steketee, & Greene, 2003).

Why do People Hoard?

There are several reasons why individuals may hoard:

  • Physical limitations make cleaning difficult,
  • Fear of losing valuable personal information,
  • Fear of losing valuable items,
  • The items are thought to be valuable, even if they are old and broken,
  • The items provide a sense of security, and
  • The items are a substitute for love not found in other people (Clark County Hoarding Task Force, 2006).

Collectors are proud to display their items

Hoarding vs. Collecting

Hoarding is not the same as collecting. A collector has a sense of pride about their possessions. Collectors want to organize and display their items. They like telling others about their collection. Adding additional items to the collection makes them happy. These individuals collect within their budget and time. Hoarders do not organize their items. Gathering additional items makes them sad or even ashamed. They do not want others to know about all the items that fill their house (Brown & Meszaros, 2007).

Clutter Image Ratings

People do not agree on what is a messy home. What is thought of as cluttered to some may just have a “lived in” look to others. Because of this, it can be difficult to determine if there is a hoarding problem (International OCD Foundation, 2014). The Clutter Image Rating scale is commonly used tool to document the living environment of people who hoard. The Clutter Image Rating scale addresses this issue. It is recommended that individuals that have clutter at Level 4 or higher seek help for hoarding (see Clutter Image Ratings for Bedroom, Kitchen, and Living room below) (International OCD Foundation, 2014). Ongoing research in the Clutter Imaging Rating Scale is actively being performed to validate this technique (Sagayadevan et al., 2016).


Clutter image rating scale – Bedroom


Clutter image rating scale – Kitchen


Clutter image rating scale – Living Room


Day M. R. & McCarthy, G. (2016) Animal Hoarding: A Serious Public Health Issue. Annuals of Nursing and Practice 3(4) 1054 http://www.jscimedcentral.com/Nursing/nursing-3-1054.pdf

American Psychiatric Association. (n.d.). Expert Q & A: Hoarding disorder. Retrieved from https://psychiatry.org/patients-families/hoarding-disorder/expert-qa?_ga=1.2565299.2060926327.1464566546

Brown, W. A., & Meszaros, Z. (2007). Hoarding. Psychiatric Times, 24(13), 50-50.

Clark County Hoarding Task Force. (2006, December). Guidelines for the investigation of hoarding Behavior and Issues with elder, child, and animal abuse or neglect caused by hoarding behavior. Retrieved January 7, 2017, from http://vet.tufts.edu/wp-content/uploads/TFGuidelines.pdf

Frost, R. O., Steketee, G., & Greene, K. A. (2003). Cognitive and behavioral treatment of compulsive hoarding. Brief Treatment and Crisis Intervention, 3(3), 323.

International OCD Foundation. (2014). Hoarding Center: Clutter image rating. Retrieved from http://hoardingdisordersuk.org/wp-content/uploads/2014/01/clutter-image-ratings.pdf

Neziroglu, F. (2015). Hoarding: The basics. Retrieved from https://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics

Sagayadevan, V., Lau, Y. W., Ong, C., Lee, S. P., Chong, S. A., & Subramaniam, M. (2016). Validation of the clutter image rating (CIR) scale among psychiatric outpatients in Singapore. BioMed Central psychiatry, 16(1), 407.

Last updated: June 7, 2020 at 16:32 pm by
I. M. Abumaria, Doctor of Nursing Practice
Version 2.00