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A habit they can't give up

What makes people store so much stuff that they can barely get in their house? Or is there a reason to care that they do?

By STEPHEN NOHLGREN
Published March 10, 2005

	[Times photo: Kinfay Moroti]
	A view looking through the front door of Terri Amato's mobile home in Tarpon Springs reveals her obsession with hoarding everyday items. Sun Valley Estates recently foreclosed on the home, the mess intact months after she died.

Most every extended family contains a few packrats.

A man retrieves broken-down bicycles from the dump, swears he'll repair them but never does. A woman saves every picture her now-adult children ever colored, plus boxes of newspaper recipes and dusty stuffed animals. Her spare bedroom is so packed her visiting children stay in motels.

Sometimes packrats go wild, descending into a dysfunctional realm known as compulsive hoarding. They can't bring themselves to throw anything out, even junk mail or empty cereal boxes. Their homes become overstuffed warrens that only an archaeologist could love.

These collectors of questionable booty are more common than most people would suspect. Experts estimate that 700,000 to 1.4-million Americans are hoarders, which translates to something like 10,000 in the Tampa Bay area. They accumulate quietly behind closed doors and efforts to change their habits usually fail.

Hoarding stems from deep-rooted psychological conditions that academics and advocates have only recently begun to plumb. They exchanged theories during the joint annual meeting of the National Council on Aging and American Society on Aging this week in Philadelphia.

None could say with any assurance what makes hoarders tick.

"There's no one profile. It's more like a syndrome," said Henriette Kellum of adult protective services in Arlington, Va.

Terri Amato was an amiable Tarpon Springs resident who rode the bus every day to Countryside Mall to shop and exercise. Viewed from the curb, her double-wide mobile home was nearly pristine.

When she died last summer at 82, however, administrators of Sun Valley Estates entered her home and discovered a 10-year trove of junk and garbage. Waist-high piles filled every cranny of every room, leaving only a narrow aisle from her bedroom to the kitchen to the front door.

Every piece of furniture was covered. She died on a layer of newspapers that blanketed her bed.

In her own way, Amato was neat and organized. She stacked newspapers in perfectly balanced columns almost to the ceiling. Some dated to 1994, when she arrived in the park. She washed empty chocolate milk bottles and filled them with clean water for storage. She wrapped garbage tightly in plastic bags from Publix and the St. Petersburg Times.

"I don't understand it," said Sun Valley community manager Dan Beaty. "We have garbage pickup twice a week."

But hoarding has nothing to do with garbage pickup, experts say.

"Clinical hoarding is usually associated with distress and functional impairment," geriatric care manager Emily Saltz said Wednesday. "In the elderly, it's often linked to unresolved grief. Hoarders usually live alone and are very isolated. It takes years to build up this stuff."

Some hoarders suffer from obsessive-compulsive disorder. Some talk of the Depression and seem to fear deprivation. Some are extreme perfectionists - driven by fear that they will throw something out, then need it later.

And some are entering early stages of dementia, Saltz said. "In the face of loss of identity and loss of skills, all that is left is control of objects."

People with money often turn to Home Shopping Network and mail-order catalogs, buying multiple versions of the same object. They pile up with the price tags still attached. One woman ended up with drawer after drawer of white gloves.

"Other people hoard things off the street," Kellum said. "Old mattresses and other people's trash. They say, "This is too good to throw away.' Beds, broken chairs, coat hangers. They think it is going to come to good use sometime."

Whereas hobby collectors usually organize and store their stamps or dolls neatly, hoarders can't seem to categorize anything. Each object is unique and valuable, whether it's this month's light bill or a stack of long-expired bus passes.

"They fear if they throw it out, they will forget what's in it," said Saltz. "It's not just a piece of paper, but an article from 20 years ago that has one sentence different than all others."

Hoarders often think their collections might have value to others. One woman kept newspapers, sure her grandchildren, not yet born, would want to read about events that took place during her life.

A 62-year-old St. Petersburg woman knows the feeling.

After eating frozen dinners, she cleans the foam dish and crams it into her cupboards, which are full to the brim.

"I keep thinking I will read in the paper that some crafts class might need them for mixing paints with," she said.

Vivacious and smartly dressed, the woman agreed to be interviewed only if her name wasn't published. She fears her bosses would treat her differently if they had any inkling of the clutter that engulfs her home.

Piles consume all available space, except her bed, bathroom and a slice of couch where she watches television.

Her main passion is shoes and clothes. They jam closets, hang from open doors, fill plastic bags and form loose piles in the living room. Just the clothes clogging her garage could stock a boutique.

What gives?

"They're still good. I paid good money for them," she says.

Furthermore, it's nobody's business. "I go out with friends every day. I eat out all the time. I only come here to sleep. Who is it hurting?"

Whether hoarders are hurting themselves - and might need intervention - is an important ethical question that academics and advocates struggle with.

Kellum recalls a woman who bought a second house after her first house filled up and she couldn't open the front door. Her car became so stuffed she couldn't drive it. So she bought a new car, then another, then another. Two houses, four cars and counting. She could afford them, so who's to say she shouldn't have them?

Hoarding, however, does bring risk. In 1997, an 85-year-old Clearwater woman burned to death in her home when a hot plate went awry as she slept. Hot plates are common hoarder replacements when junk overtakes their stoves and ovens. Firefighters were thwarted by newspapers stacked to the ceiling that turned the woman's house into a tinderbox.

Still, "we allow people to smoke and endanger themselves and other people, yet we say it's not okay for hoarders to endanger themselves," said Margit Novack, president of Moving Solutions, a Pennsylvania company that helps people downsize and move. "It's easy to go in and say, "It's wrong, it's bizarre.' Yet there is a right to self-determination. There are no easy answers."

Animal hoarders sometimes attract publicity but are only a small subset of a broader phenomenon, panelists said. When neighbors complain about smells or mangy pets, authorities step in to enforce housing codes or prevent animal abuse.

Florida's Department of Children and Families investigates self-neglect of older people, and can move them to nursing homes or assisted living homes. That might apply to frail hoarders who keep falling and hurting themselves because their homes are so cluttered, said Gary Vitucci, a DCF supervisor.

But even extreme hoarding alone is not grounds for intervention.

"If the person is mentally competent and can accept the risk, that's part of being in a free country," Vitucci said. "As you get older, you get more of whatever it is you are. Nice people get nicer. Mean people get meaner. And people who collect things collect more."

The St. Petersburg woman acknowledges that her clutter affects her life. She allows only a few close friends to visit her house. She can't play her beloved piano because she can't get to it. But she doesn't feel compulsive or overly distressed.

"I can stop any time," she says.

Her accumulations began in earnest about 10 years ago when her adult son left home. "If I had a wonderful man in my life," she says, "you wouldn't believe what I could do" to clean up the house.

Hoarding does not run in the woman's family, which is unusual. One study of 19 hoarders showed that 16 had relatives who hoarded. A Stanford researcher has found differences in brain scans between compulsive hoarders and nonhoarders.

The power of genetics may help explain why most hoarders are so intractable. About 20 to 30 percent of people diagnosed with obsessive-compulsive disorder are hoarders. But medicines that ease other compulsions don't seem to ease their urge to hoard.

Occasionally, judges or landlords force hoarders to cull their stashes when neighbors complain of smells and fire hazards. But typically, hoarders will refill their spaces in short order.

One woman had to move to a one-room apartment and couldn't keep her two dogs. A sympathetic veterinarian kept them for her. When they died, she couldn't decide how to dispose of their bodies. So they stayed in the vet's freezer.

[Last modified March 10, 2005, 06:39:32]