My mom has hoarding disorder, which progressed to a significantly worse state after her mother passed away. It is common for people who show signs of hoarding disorder to progress to a significantly worse state after losing something important to them, especially a loved one.

My mother acquires things easily, going on shopping trips several times a week. She is unable to discard items, however. For example, she is unable to throw any mail away, so she has boxes and boxes of what most people would refer to as "junk mail."

This constant acquisition with no ability to discard items lead to her home being filled with stuff, with only small pathways to maneuver around.

This lead to very large challenges with keeping the home livable. Her two dogs began peeing and pooping exclusively inside the home on the carpet. My mom would generally leave the urine permanently and she would let the feces dry out for several days before picking it up with paper towels. This animal waste, along with the decomposing materials all around her house, lead to a highly toxic and unsafe breathing environment. As a result, she was coughing constantly. She could not get through a single sentence without coughing throughout. She also had sinus issues, where her sinuses would would become irritated and inflamed, leading to horrendous headaches that would cause her to need to lie down for days at a time.

She did not connect these health issues, in any way, to the toxic living environment around her. Nor did she understand or agree that the air in her home was unsafe and unhealthy to be breathing.

After much effort on my part, including doing research online with hoarding specialists (therapists and psychologists who specialize in hoarding) and making many mistakes, I was able to work with her to allow me to remove the carpet, install a dog door, potty train the dogs, and clean her heating duct work. Although the home still has decomposing materials throughout and still too much stuff, this improvement lead to significantly safer and better indoor air quality. Her coughing cleared up within a couple of days of all this work and her sinuses flair up about a tenth of the time that they used to. Remarkably, she was unaware of the improvements in her coughing, not realizing she was coughing pretty much any time she was speaking and even having fits when she wasn't speaking.

Although my mom still has hoarding disorder issues, I feel good about the significant improvements we made which have dramatically improved her health.

It was a very frustrating and challenging process, as my mother often heard criticism or condescension when I was trying to help and would "shut down." I would often need to leave in the middle of a project because she was often combative and/or upset to the point that progress would not be possible. After leaving, I would revisit helpful websites and learn how to approach her differently. It was (and still is) a challenge to work around her many confounding issues and triggers. Progress is a part of the process, but she often regresses to old habits with even the slightest stressor. She also regresses to old habits in the absence of help.

If you have successfully helped someone with hoarding disorder, I would greatly appreciate hearing some of the strategies you found effective.