Hoarding Disorder Is More Common Than You Think: How to Help

In 2024, shortly before her father died, Madison Lovelle entered his home for the first time in 17 years. They’d shared a loving, supportive relationship for the entirety of her 40 years, but like many children of hoarders, myself included, she preferred to spend time with him elsewhere. The mountain of things inside his home just made it too unsafe, unsanitary and uncomfortable for a visit. Now, though, her dad was ill: Following a stroke, she was there to take care of him. His hoarding disorder made care difficult. “He was upstairs, and he could not get downstairs,” she told USA Today, but had begged her not to call EMS because he didn’t want strangers in his home. “And honestly, I don’t know that they would have been able to get through there,” she said.

“You can’t make sense out of it, but there was this connection to the stuff,” Lovelle said. “He genuinely was worried about that stuff going in the trash. And it really did cause him a lot of anxiety.”

Hoarding disorder is more common than most people realize, and is estimated to affect between 2% and 6% of the population according to the International OCD Foundation. Stigma keeps many families silent and struggling alone. Symptoms are most prevalent in adults 55 and older, and tend to grow more severe with age. Caring for her father, Lovelle faced challenges that scores of other families quietly confront, often without the support or resources to effectively help their loved ones.

Clinically, hoarding disorder falls under obsessive-compulsive and related disorders. It affects executive functioning and organizational ability, making it nearly impossible for people with hoarding disorder to stop collecting things or let anything go. “It’s not laziness. It’s not being a slob. It is a psychiatric issue,” explained Anne Pagano, a clinical social worker and founder of the Hoarding Disorder Resource and Training Group in Westchester, New York. Some people with hoarding disorder even experience “clutter blindness,” meaning they genuinely cannot see what others see in their living space.

Hoarding disorder can take root in childhood or be triggered by trauma, and often runs in families with both genetic and generational components. “Our parents teach us what to value, what to not value,” said Mary Dozier, an associate professor of psychology at Mississippi State University who studies hoarding. Sometimes the inheritance is literal, she said, with surviving family members left to clean up a hoarded home becoming so overwhelmed that the cycle simply moves into the next generation.

Experts suggest that loved ones looking to help avoid one of the most egregious errors that many well-intentioned people make: clearing out a person’s home without their permission. It’s the worst thing a caregiver can do, Pagano said, and can cause acute distress without resolving the underlying issue.

Instead, Pagano and Dozier recommend gentle, boundary-focused conversations that include a clear expression of concerns and safety risks while inviting the patient to confront their hoarding habits. Dozier also offered questions that focus a patient’s current goals and guide their cleaning and decluttering. Do they want to age in place? Move to a retirement community? Cook more at home? Each endpoint requires specific work that can make the conversation feel less like an attack and more like support.

Loved ones should also note that hoarding disorder carries a high relapse rate, meaning that even after a home is cleaned out, the work isn’t over. Regular check-ins from family members, friends or case workers are essential to keep clutter from building back up. “Having that oversight or that supervision really is mandatory, or else there’s going to be a slippery slope,” Pagano said. “It’s not a quick fix.”