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Given such extreme circumstances, the priorities set by family, friends, professionals, and the authorities move from simply supporting the hoarder to remedying a sometimes life-threatening situation. If the hoarder is facing the threat of having his or her children removed, then an intervention can be an option for putting the children first and finding a way to keep the family together. Usually there isn’t any pretense that the hoarder is in charge of the process.

An intervention is the option of last resort and is usually a major decision. It can’t be undone. Interventions should only be undertaken after serious thought and preceded by family meetings, consultation with a therapist or hoarding specialist, and discussions with the authorities. Aside from the physical issues of the cleanup, any concerns about the hoarder’s mental state (depression, severe anxiety, or suicide) should be discussed with a therapist or specialist before the intervention. This is a really big deal, and an apology will not fix this decision after the fact. Families choosing this option need to appreciate and prepare for all of the consequences, including a complete rejection by the hoarder.

4

THE PLAN: LAYING THE GROUND - WORK

A cleanup is not a linear process, with one step leading neatly to the next. Every situation has its own course that requires a lot of patience, insight, and flexibility to navigate. But each cleanup needs to include some key elements in order to succeed.

Whoever instigates the cleanup, which in most cases is a close family member but which can be a friend or professional, will need to answer these questions, among others:

What am I dealing with in this situation?

Who are all the people involved? (Spouse, children, friends, and neighbors)

How can I get the hoarder on board with this cleanup?

Who will help me?

What are the expectations and goals we should have?

Is there a timeline that we need to follow for the cleanup?

What happens if the best-laid plans go awry?

ASSESSING THE CLEANUP

In the previous chapters of this book, we looked at the what, who, and why of hoarding, which provide the foundation for building an effective effort. Each situation is unique, but by identifying each part of the problem, you can determine the best overall approach.

The optimal cleanup looks like Roger’s: The hoarder is involved because the family has patiently coaxed him in that direction. By the time he is ready to start, the family has a plan in place to be able to move ahead. Roger’s sisters spent quality time assessing the situation and determining how the cleanup could take place.

Kathy knew what her parents’ house looked like, but even she was surprised when the team showed up for the first cleaning. Roger’s hoarding had spread throughout the house, and she wasn’t expecting to see the extent of the clutter. Hoarding can move quickly after trauma.

Kathy knew that she could handle seeing her parents’ house a mess. But some other family members might have gotten too upset, so it was important to make sure that everyone involved was prepared—and that whatever they might feel about Roger’s part in creating the mess would be held back. If there is a family member who tends to get anxious or angry, is easily grossed out or overtly critical, that person is not the right one to assess the condition of the house or to help during the cleanup.

Someone does need to visit and determine the severity of the hoarding and what’s being hoarded, so that the planner can figure out how other team members might be helpful. It’s great if this is someone who can stay in touch with the hoarder and visit again, to reassess when cleaning time is near.

Even if Roger had not been cooperative, the plan that his family put in place was flexible enough—and they were patient enough—to let things take their course without undue pressure.

An important part of the plan—and perhaps the most obvious one—was how to actually accomplish the cleanup. Roger’s family felt that they could take care of things themselves