Hetty Mitchell found it comforting to collect things as a child and the tendency grew, with her, to include what she found most beautiful: fabrics, unique clothing, beads and treasures from nature.
When the problem peaked more than a year ago, Mitchell’s studio apartment in downtown Tucson was packed to the ceiling with boxes and boxes of mesquite pods, and bags and piles of clothing, particularly denim.
She had plans for her collection. The pods were to become Christmas ornaments and the denim, elaborate quilts. But Mitchell, 80, never moved beyond gathering her materials. When her landlord told her she had to clean up or move out, Mitchell set about the painful tasks of both sorting her collection and facing the reasons she had become so overwhelmed by stuff.
Mitchell’s situation is far from unique, and some believe it is growing as our population ages. Roughly 210,000 people in Pima County are 60 and older, and nearly 20,000 are 85 and older, reports the Pima Council on Aging. By 2020, 1 in 4 Arizona residents will be over 60 years old, the 2010 census projected.
The problem of hoarding, and the question of how to help, has become so challenging for agencies here — from firefighters to city code enforcement workers to social workers — that a task force of about 50 agencies has been established.
Members study hoarding and share their insights, and in March they will offer their first educational program, “Buried in Treasures,” for anyone who wants help with this difficult-to-reverse problem. The 20-week program and support group begins with an informational meeting and sign-ups at 4:30 p.m. on March 3 at the Abrams Public Health Center, 3950 S. Country Club Road, Room 1104.
Those who attend will learn how to decrease symptoms of hoarding, learn skills to reduce clutter and improve their ability to use their home, said Lisa O’Neill, a task force founder who also is director of education and elder abuse resources at the University of Arizona’s Center on Aging.
Impulse begins EARLY
While hoarding tendencies often become more evident in later life, the impulse to collect usually begins between the ages of 11 and 20.
Often, it’s only after people stop being curtailed by social norms, and the expectations of parents and housemates, that the inclination grows. People who hoard often live alone and are isolated — hoarding, in turn, compounds their isolation.
Previously thought to be a type of obsessive-compulsive disorder, studies have clarified that while roughly 20 percent of people who hoard have OCD, about 50 percent suffer from depression. One of the highest indicators — at 84 percent — is having a close family member with hoarding tendencies. Sometimes the impulse to collect things follows a traumatic event, such as a divorce or the death of a loved one, and other times it begins after a person develops dementia.
The Diagnostic and Statistical Manual of Mental Disorders now classifies hoarding as its own distinct category, with the average age of those seeking help being 50. Studies are ongoing as to whether hoarding is more common among older people, or if it just becomes more progressive due to physical and mental challenges people experience as they age.
The problem brings with it significant health and safety risks for the person who hoards as well as the community. Nationwide over the last 12 months, at least one firefighter and two elderly people have died due to cluttered residences creating heavy fire loads and blocked exits.
“It’s definitely more of a defensive situation,” said Tucson Fire Department spokesman Captain Barrett Baker, in describing how they fight hoarding fires differently. “They certainly pose a lot of different challenges and, from a rescue standpoint, they are a lot more dangerous not just for the person who is in there, but also for us.”
Privacy laws make it tricky to address, he said, because medics do not have the right to intrude while making house calls. So, when they see a house that is extremely cluttered, firefighters and medics contact the city of Tucson’s code enforcement officers.
Rick Saldate, code enforcement supervisor with the city of Tucson’s Housing and Community Services Department, believes they are seeing more hoarding cases now, but they don’t track them so it’s impossible to know for sure.
“We seem to at least deal with a hoarder or two every two weeks,” he said. Many, he said, end up needing to leave their home or apartment.
“By the time we get called in, utilities don’t function or the infrastructure has gone out,” he said. When the person can no longer live at the home, Saldate said, enforcement officers often call in Adult Protective Services or the Primavera Foundation, which helps people facing homelessness, to find a temporary placement.
“If you are the person living next door, it’s very cut and dry. You want to stop it and get them to clean up,” he said. “That pressures us, as a municipality, to tighten up our code while at the same time trying to understand the mental and human component of it.”
People who hoard animals are especially prone to evictions.
“Typically, the living conditions are unhealthy for both the animals and the people,” said Jose Chavez, enforcement operations manager with Pima Animal Care Center. Chavez’s agency sees about one case every three months, he said, and they find older people who hoard animals often have some form of dementia or mental illness.
There is no stereotypical hoarder.
“Some are as clean as you and I, and they might have shelves throughout the house that you need to shimmy in between,” Saldate said. Over the years, he said his department has shut down the homes of poor residents and wealthy residents alike, including University of Arizona professors and successful businesspeople.
“Every time I put a label on it,” he said, “it doesn’t take very long for something else to arise that’s completely the opposite.”
Jennifer Hagan has been a caseworker with seniors for six years, first for Our Family Services and now with the Pima Council on Aging. Many of the people she visits each week have hoarding tendencies, something Hagan said she might sometimes have missed before she learned more through the task force.
“Before, I used to think, ‘Oh, their home is just a little cluttered,’ ” she said. “Now I know that, no, it’s more than just being cluttered.”
Hagan and her colleagues do not take on cases simply for hoarding, but only when residents need help with other daily life activities, such as meal preparations, bathing and grooming, and maintaining finances. They have a waiting list of nearly 100.
“A lot of people don’t get the help they need,” she said. For those with hoarding tendencies, one of the biggest challenges is finding resources for counseling, she said.
Debra Adams, PCOA’s chief operating officer, said about eight years ago, they were assisting about 2,100 people on a regular basis but today — due to federal and state funding cuts — can only help about 1,100.
“Our sources of funding to assist people in their homes have steadily been eroded away,” she said. “At this point in time, with what we’re seeing in the governor’s proposed budget, it appears that there is not a recommendation to increase funding that we receive from the state.”
return to childhood
When Mitchell reflects on her compulsion to save so many things, she quickly returns to childhood.
She grew up the middle of three daughters, under the tyranny of an angry, alcoholic father and an emotionally unsupportive mother, she said. She remembers, early on, experiencing deep feelings of loneliness and anxiety, and a tendency to assign an unusual degree of significance to inanimate things, such as her toys.
Hearing of the atrocities of World War II or the suffering of an animal were unbearable for her, but she said her parents rejected her feelings. “I missed out on all the self-soothing patterns that are established and learned in a healthy parent-child relationship,” she said.
Fortunately, a powerful love for the natural world took hold when she was a child and grew during her life, eventually bringing her to Alaska, where she worked for the U.S. Park Service. But when the oil crisis took hold, she lost her job. She loved Alaska and didn’t want to leave, so she started earning a living by selling one-of-a-kind clothing and beads at fairs and shows around the state.
“At that time, I just started accumulating more and more stuff,” she said. “It was still livable, though. It wasn’t like you could hardly walk through the rooms.”
It wasn’t until she moved to Tucson that things became “basically out of control,” Mitchell said. Sorting through the things in her Tucson apartment took time, and the support of family, a counselor and her friend Robin McArdle, the services supervisor at Armory Park Senior Center.
“Depression and isolation exacerbated the feeling of, ‘You’d better hang onto that because you might need it someday,’ ” Mitchell said. “I also have had this fear of not having enough. It’s just kind of a generalized feeling that something is missing and I don’t know what. It’s only now that I know it was partly the situation in my early years, my family situation, and the psychological stuff from all those years.”
Pile by pile, box by box, Mitchell picked out her favorite pods, and which clothes to donate to charity. “I couldn’t see it for what it was with collecting,” she said. “It was just so very hard for me to give up on any of it.”
When hoarding cases are brought the attention of Adult Protective Services, a primary goal becomes reducing harm, to both the person involved and to his or her family, said Rae Vermeal, district program director with Adult Protective Services.
“There’s so much shame involved with this issue that people isolate themselves and don’t let people into their homes,” Vermeal said. “We need more understanding and more compassion and, hopefully, more resources.”
Hoarding cases are not something her agency can handle on its own.
“The task force is really helpful because there’s no one entity that can handle alone the issue of hoarding, and how to help people,” she said. “It takes collaboration from the community.”
O’Neill, with the UA’s Center on Aging, said that whenever possible, they take their time helping people. When items are removed, she said, the level of anxiety for the person who hoards often rises tremendously. The issues behind the hoarding must be addressed to avoid relapse, she said.
“Without counseling,” she said, “they are going to go right back to where they were.”