Are You or Someone You Know “Buried in Treasures” (Hoarding)?

By Jessica Novello, MS, RN, CDP


Did you know that hoarding behaviors are more common among adults over 60 years of age and among persons with anxiety and depression? Behaviors may be triggered by past experiences or a recent loss. There is an overall prevalence of hoarding disorder in 2.6% in the population. This means that most people may know a person affected by hoarding disorder or may be affected themselves. Since hoarding behaviors have a mental health aspect (it is a psychological condition) and an environmental/health safety aspect (the home often becomes unsafe or hazardous)- this condition can feel very overwhelming and involves a cautious, respectful, and diligent team approach for proper treatment. There is education, resources, and support if you or someone you love is “buried in treasures”*.


*The term “buried in treasures” comes from a book and workshop series on hoarding. I prefer this terminology as it feels less stigmatizing than “hoarder”. It is important to remember that a person affected by hoarding disorder is not just a “hoarder”- they are often a parent, sibling, friend, or valued community member who has been affected by a serious behavioral condition. A more sensitive way to refer to the person and condition would be a “person affected by hoarding disorder”, not a “hoarder”. It is important to remember that regardless of what we are going through, we are people first and not classified by a mental heath diagnosis alone.


Hoarding is a serious mental health condition. It is more than a messy home or a collection of treasures or even trash. Being a collector and collecting a specific type of item in an organized matter- stamps, records, art is distinct from hoarding disorder. Hoarding involves a substantial difficulty in parting with items and a true perceived need to save items. There is often significant disorganization and distress in parting with items (whether they have value or not). To receive a medical diagnosis of hoarding, the level of collection in the home must interfere with function or safety and cannot be explained by another overriding physical or mental health condition.


Hoarding can be diagnosed. It is a unique condition in the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5). Cleaning out the home, without other mental health interventions and supports can be very traumatic for people experiencing a hoarding disorder. Focusing on the home/items alone often does not provide enough support to address the behavior or thought pattern involved with hoarding behaviors. Interdisciplinary support is often needed to navigate and remediate hoarding disorder (for the person, family, and home).


Hoarding treatment and remediation often involves a team approach. Important parts of the team may include:

  • Public resources: fire department, animal welfare, crisis services, and/or adult protective services (APS);
  • Healthcare resources: mental health professionals/counselors, specialists, primary care doctors, social workers, and/or aging life care managers;
  • Private businesses: cleaning services, organization/downsizing professionals, storage services, biohazard/sanitization services, and/or handymen.
  • Social support: support groups (online or live) for the affected person and/or their family and care team.


Safety is a priority for the affected person, the home, and the care/support team. Understand that hoarding behaviors may worsen before improvement and treatments take time and work. Professionals, friends, and family who are working with a loved one that is hoarding need to take care of themselves first- be aware of your surroundings, wear protective clothing and equipment (as needed), take breaks, and seek resources and supports for yourself. It is important that the team respects all aspects of confidentiality and is as emotionally supportive as possible without compromising their own ability to be a help/resource.


It’s critical to know your resources and supports (national and local):


More information on diagnosing hoarding disorder and working with hoarding situations: