In a perfect world, if I had my way, hoarding would be addressed before it became a safety concern. People who hoard would work through their relational traumas and losses, there would be no stigma in our culture preventing people who hoard from getting help, mental health professionals would be busy helping their clients experience success at understanding why they hoard, and then people would stop hoarding and live healthy and well. There would be no crisis, no need for forced clean-outs (what has to happen when a homeowner will not cooperate with the city and the city has to clean-out the home), no more trauma, no more animals being harmed.

Obviously, the world is not perfect, and most often we don’t know about a hoarding problem until it has reached a level of un-safety and crisis. Some people who hoard are ready to make changes and they do work with mental health professionals to understand why they hoard and when they have a clear understanding of themselves, they can begin the hard work of going through their hoard and recycling/donating/trashing/giving away/keeping. This takes a long time – people can be successful, I’ve worked with some – and it takes years. So it’s a long haul.

And, many people who hoard will never agree to stop their behaviors. They will not completely clean out their homes. BUT, they will be willing to work on a harm reduction plan. What’s harm reduction, you ask? It’s a way to allow people who hoard to keep many of their things, to continue to collect items, but live safely in their homes. And by “safely,” I mean the city doesn’t have a need to enter the home, family members and professionals don’t worry that their loved one/client will be living in an unsafe home. Harm reduction is a middle ground. Some people who accomplish harm reduction do decide to continue with a plan to completely clean out their homes and stop hoarding. Many stop at the point of reduction. But the goal has been successfully met, right? So this is a good solution. Here’s what it looks like.

You go back to the list of five safety requirements: working smoke alarms, cleared entrances and exits, three foot pathways, no flammable materials, cleared electrical outlets. Once these five requirements have been completed, if there is no hazardous material in the home, it is likely that a person is safe to live in their home. The great advantage to a harm reduction plan is that the person who hoards is the one making the decisions about what stays and goes. They have autonomy – we may not agree with their decisions, but these decisions are theirs to make. As long as the requirements are met, it has to be ok with me that my loved one fills their living room with boxes of papers rather than furniture. Their choice.

So, how to help a person who hoards come to a harm reduced safe space. Here’s a tip: get blue painter’s tape and put it down on the floor to mark the 3 foot pathways – nothing can go inside of this 3 foot space. Tape on the entryway – nothing can go here; tape in front of the windows . . . you get my point. When we say “3 feet” that might be hard to fully know what that looks like . . . with painter’s tape on the floor marking the space, there’s no question. Your job can then be to help remove the items the person who hoards has decided they can live without.

You – the family member or friend – may not think this is the solution you are happiest with. Probably your loved one doesn’t think this is the best solution either. They would keep everything, you would get rid of most everything. This is a half-way meeting point, a compromise. Remember, the relationship is more important than the stuff!

Janet Yeats is a marriage and family therapist and writer who specializes in issues of trauma, grief and loss. Janet consults, speaks and writes on hoarding disorder as well as other trauma and loss-related topics. Visit her youtube channel (Janet Yeats) to see videos and webinars on these topics.