Clutter is a temporary state that can be easily amended. Books can be put away, clothes put in their respective spots, papers filed, and miscellaneous "things" put away. "A place for everything and everything in its place" is achievable, but is on a minor (or perhaps extended) hiatus. Clutter is recognized as a provisional status that can be improved relatively easily, and without a major meltdown when items need to be downsized. Clutter is a home in the middle of a busy week, with chores lingering incomplete, as another appointment is rushed off to. Clutter is an elderly loved one's home filled with a lifetime of memories that have been taken out and reminisced over, but not placed back in their particular place of repose. Perhaps the lack of upkeep is due to an illness, injury, lack of mobility, or just the general slowing down associated with old age. Clutter is easily (or perhaps arduously) tidied up with assistance from family, friends, or paid help.
Yet, what if every piece is "too special to part with." How does one address an elderly loved one that is a self-professed collector and unwilling to part with their beloved belongings? Could it really be bona fide collecting or is it the beginning stages of hoarding, lurking insidiously in the wings?
Collecting is a hobby, a very distinct activity (and in extreme cases lifestyle) that can be rationalized, legitimized, and ultimately controlled. It is generally agreed upon that collectors, no matter how extreme or kitsch their interests may seem, take pride in their acquisitions. They are proud to show them off to friends, family, and even like-minded strangers. Collectors keep their acquisitions maintained and organized, although with the general slowing down associated with aging this may be more difficult to keep up with. Collectors are able to live a functional life outside of their belongings. In some cases, extreme collecting can be a symptom of an Obsessive-Compulsive Disorder. Yet, this diagnosis does not equate to hoarding; a collector with OCD is not automatically considered to be a hoarder and hoarders do not always have an Obsessive-Compulsive Disorder.
Hoarding is when the acquisition of belongings has expanded beyond the boundaries of what is rational. Most hoarding typically has no clear and distinct goal of acquisition. In cases of hoarding, items are not maintained or able to be rationally organized. There is rarely a sense of pride in their belongings or upkeep although there is a clear need, compulsion, and desire for their acquisition. The sense of pride for a collector denigrates to shame and/or embarrassment for the hoarder. Visitors often become increasingly unwelcome as the hoarding progresses. This is usually due in part to peoples' reactions to the emerging and evolving backslide into hoarding. Unfortunately, the knee jerk reactions to the overwhelming chaos of a hoarding situation can lead to harsh words, unintended insults, and further isolation of the hoarder.
There are 2 main, and very different approaches, to hoarding interventions.
Hoarding is a mental disorder, either as symptom of another disorder or a disorder in itself. With this in mind, the preferred mode of intervention is the Social/Human Services approach. This focuses on the individual hoarder and their health, both physical and mental. Psychological and medical issues are addressed in the context of the housing issues. The success of this intervention is contingent on the awareness of the hoarder of their situation and their willingness to accept mental health assistance, along with other outreach services. Keep in mind that this social/human services approach doesn't have any legal authority and can only be successful in conjunction with the hoarder's consent and participation.
The Code Enforcement Model is sometimes necessary when the need for intervention is immediate or when other avenues have not succeeded. This usually initially involves First Responders who in turn refer to Department of Health and Elder Services professionals. Housing and Building Standards usually round up the pack as they have the legal authority to get the "wheels in motion" to aid an unwilling participant. Typically, the Housing Department is charged with assuring economic and social stability of neighborhoods and their structures while combatting blight and squalor. The Housing Department in conjunction with Health and Social Services divisions are collectively charged with protecting the health, safety, and welfare of all residents. This is accomplished through the enforcement of minimum standards of health, safety, fire protection, cleanliness, maintenance, occupancy, and even standards of lighting and ventilation for residential properties.