Ten top tips when working with adults who hoard

With around 1.2 million people in the UK affected by hoarding, how can social workers support adults who hoard to change their behaviour?

Very cluttered room
Photo: West Yorkshire Fire and Rescue Service

This article presents practice tips from Community Care Inform Adults’ guide on self neglect: working with adults who hoard, last updated in July 2023. The full guide gives an understanding of the different types of hoarding and the reasons why someone might hoard, and outlines the legal framework for working with people who hoard. Inform Adults subscribers can access the full content here.

The guide is written by Deborah Barnett, a safeguarding adults consultant and trainer, and the author of Self-neglect and hoarding: a guide to safeguarding and support (Jessica Kingsley Publishers, 2018).

Hoarding can be described as the collecting of, and inability to discard, large quantities of, goods, objects or information. It may involve neglecting aspects of the home and/or self, resulting in poor sanitary conditions and social isolation.

Hoarding has implications for physical and mental health, wellbeing, housing tenure and safety, which is why intervention to help the person change their hoarding behaviour is so important.

The earlier the intervention, the easier it is for the person to consider change.

When working with someone who hoards, seek to:

  1. Develop a rapport.
  2. Find activities, work or education that the person enjoyed doing and try to help them engage in community activities.
  3. Understand what feelings the person has about themselves, their house and why things are the way they are.
  4. Use a strengths-based approach to determine the positive things that a person has in their life or can achieve for themselves and how they would like to manage risk.
  5. Consider trauma-informed approaches and methods of motivation and communication.
  6. Create cognitive dissonance – the difference between the person and their behaviours – to help them see themselves more positively.
  7. Take one small step at a time with lots of encouragement.
  8. Use a multi-agency response.
  9. Consider wider safeguarding issues such as hate crime, domestic abuse, anti-social behaviour, safeguarding other adults or children in the property or historical abuse.
  10. Do not force change if at all possible.

Gaining a person’s trust and supporting them to make change often takes time. Social workers and occupational therapists should work with the pace of the individual concerned whenever possible. Where risks are identified, cases should not be closed because of a lack of engagement without a thorough risk assessment and alternative arrangements being made to continue supporting the person.

Find out more

If you have a Community Care Inform Adults licence, log in to access the full guide and read more detailed information on hoarding and attachment, along with tools that may prove helpful in assessing and responding to hoarding cases.

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6 Responses to Ten top tips when working with adults who hoard

  1. Saz August 30, 2023 at 12:05 pm #

    Hoarding is down to emotional issue’s. If the emotional stuff isn’t resolved first, then the hoarding will not resolve along with it.

    • Nicki Brown August 30, 2023 at 2:32 pm #

      Good afternoon.
      What is the best way to help with the emotional side of hoarding. I am a key worker supporting a mum who is a hoarder.
      Any advice would be appreciated

    • Christina-Esther Chiagorom September 5, 2023 at 9:01 pm #

      Yes Saz, I agree, but I think you meant in your comment that if the emotional issue is treated, the hoarding would be resolved. It’s a very complex condition with not a lot of research and this report from Gemma.B exemplifies that, because there does not seem to be info such as evidence-based practice information- this would’ve been useful for those living with hoarders, carers, support workers, etc.

  2. Christina-Esther Chiagorom September 5, 2023 at 8:49 pm #

    I thought this report would have explored the cause of Hoarding a bit deeper including practical supportive techniques. Yes, Motivational Interviewing is essential but as a caseworker working with hoarders; there needs to be deeper work to understand the person’s mental health and trauma leading to hoard. I would have liked to know which specific Multi-agency professionals to include in supporting the adult as well as services to refer to for intensive support. Working with hoarders is ‘a easier said than done job’ – that picture at the top is very polite lol


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