Hoarding Disorder: Situations and Solutions for Property Managers

Property managers can help residents and their communities handle hoarding before it gets out of control, but they must be proactive in the effort.

Reality TV shows have brought hoarding into public consciousness. Viewers can well imagine how hoarding would present property managers with significant challenges, not least of which is abiding by Fair Housing Act disability protections. Hoarding is now recognized as a mental disorder requiring cautious and compassionate engagement with those whose lives have been impacted by this disorder. But property managers must also safeguard their communities and residents against risks posed by hoarding. It’s a delicate balance that property managers must strike to move forward— avoidance is not an option.

What is Hoarding Disorder?

The American Psychiatric Association defines hoarding disorder as a form of mental illness: “People with hoarding disorder have persistent difficulty getting rid of or parting with possessions due to a perceived need to save the items. Attempts to part with possessions create considerable distress and lead to decisions to save them. The resulting clutter disrupts the ability to use living spaces.”

Hoarding disorder is a protected disability under the Fair Housing Act. There are five levels of hoarding, ranging from Level 1: Small, temporary amounts of clutter, but requiring no action from property managers to Level 5: Severe unsanitary conditions, requiring intervention from professionals. Hoarding disorder is exhibited in individuals though various internal and external characteristics, such as anxiety, shame, shyness and reclusiveness.

Hoarding disorder may be genetic, triggered by traumatic events or a symptom of another disorder, such as depression, obsessive-compulsive disorder (OCD) or dementia. Typically, it

BY JAMES CAMPBELL, SENIOR MANAGER, INDUSTRY

begins in adolescence and increases through life, often being found in the elderly. The International OCD Foundation estimates that serious hoarding problems are present in at least one-in-50 people, with 50 years old being the average age for seeking treatment.

The resulting problems caused by residents with hoarding disorder can be daunting: Clutter in common areas, pest infestation, foul odors, poor indoor air quality, mold and mildew, and walkways and rooms that are difficult to navigate. Where pets are being hoarded, there may be noise, accumulated waste and stains. There may also be plumbing and sanitation problems, fire hazards and safety hazards affecting other residents. Residents with hoarding disorder may seek to deny onsite staff access to their apartments, resist cleanup requests and fail to report broken appli-

Hoarding Disorder — continued on page 26 ances and features. Finally, there may be significant costs for repairs, debris removal and cleaning.

Dana Faith-Page is Community Manager at American Landmark Apartments in South Carolina. Her service team flagged one such situation prior to yearly inspection: An elderly, disabled woman and her daughter. “The elder had lost her legs and utilized a wheelchair, which could no longer even maneuver in the apartment due to the amount of items,” said Faith-Page. “Even the bottom half of the bed she occupied had stacks of items piled up.”

This situation had occurred before hoarding disorder was commonly recognized. Faith-Page reached out to her state agencies regarding their concerns for elder residents’ health and welfare but did not receive much guidance at that time. Nevertheless, her onsite staff cautiously and compassionately proceeded with these two residents. They met and shared their concerns for health and safety. Her onsite staff gave them 30 days to improve conditions. The halls were immediately cleared with clutter, with items going to a trash compactor and to their vehicle.

“We advised them that we would be inspecting every 30 days to ensure the home conditions remained livable,” said Faith-Page. “While things improved and they were responsive to our monitoring, we amicably ended their residency upon lease expiration. There were a large number of charges for trash-out and replacement of carpet and further damages.”

Identifying Hoarding Disorder Situations

Hoarding disorder situations are best identified through annual maintenance inspections and checklists. Lease terms should include a unit walkthrough once per year. One key sign may be a resident’s inability to use their bathrooms or kitchens as intended. Onsite staff may call in outside assistance if they encounter severe prob- lems: The fire department for fire hazards, animal control for animals being hoarded, the health department for health and safety issues and adult protective services or other agencies for interpersonal issues.

Amy Horsley is Director of Residential Properties for Cal-American Corp. in Utah. Her onsite staff identifies hoarding disorder situations through yearly or bi-yearly inspections, plus tips from maintenance staff and vendors. Horsley’s worst case came from a 721unit apartment community in San Francisco, where yearly inspections hadn’t been done in a long time. She and her Maintenance Director went door-to-door. Horsley had one resident who continued to postpone with various excuses, a common response from residents with hoarding disorder. They knew this resident from her being friendly with office staff but sensed that something was wrong. On a fourth attempt, Horsley communicated with a notice delivered 24 hours in advance that they would be conducting their inspection regardless.

“There was garbage literally waist high,” said Horsley. “The toilet hadn’t been working in over a year. This resident was showering in the clubhouse and using the bathroom there as well. She was mortified.”

Horsley’s onsite staff began the long process of emptying the apartment, which cost over $20,000 and a full week’s time. San Francisco laws forbade eviction, and Horsley did not wish to pursue this route, instead recognizing that the resident needed help. She offered to move the resident to a studio apartment if the resident agreed that she wouldn’t take anything from the contaminated apartment. Horsley’s staff contributed to buying the resident a television, clothes, a mattress, dishes, toiletries, books, a lamp, etc. Horsley personally offered to inspect at least twice per week to make sure the resident was getting help and keeping her apartment clean.

“She agreed, and we became friends,” said Horsley. “When I left this community, she brought me roses on my last day. She thanked me, that I saved her life because she was slowly killing herself. I will never, ever forget that. She stayed at the community until she passed away from natural causes.”

Addressing Hoarding Disorder Situations

In Horsley’s case, she obtained legal help and called in adult protective services. Aiding the resident was a process that took a full year. Addressing these situations requires property managers to proceed very cautiously and to strike a delicate balance between the rights of residents under Fair Housing Act disability protections with the rights of property owners. Often, a compassionate approach yields the most successful outcomes. This approach involves being interactive with the resident, patient, non-confrontational and process-oriented, where documentation is essential.

Property managers can also be specific in their leases, establishing standards for housekeeping and accessing units upon reasonable notice. They can define rules regarding obstructions in common areas, storing flammable or explosive items, managing pets, disposing garbage, reporting mold and mildew and various other resident responsibilities. The key is to state that these rules are to protect the health and safety of all residents.

Residents with hoarding disorder may request an accommodation for their disability. If so, these accommodations must be reasonable and may include an extension of time for unit treatment and cleaning, a schedule of inspections and clear plans-of-action to fix specific cause violations. Property managers are advised to seek legal guidance.

Yvette Evans is Senior Director of Business Development for Leap Easy in Virginia. Previously, she managed an independent, low-income, seniorhousing community. Their quarterly preventative-maintenance inspections included a look at other items from a

Hoarding Disorder — continued on page 28 health and sanitary perspective. This process identified an elderly photographer with hoarding issues.

“He had boxes upon boxes of negatives and photos from his entire career stacked floor-to-ceiling in almost every inch of his apartment,” said Evans. “He was very nervous and scared that we were going to take his photos.”

Evans was joined by her Regional Manager for an inspection of the photographer’s apartment. He advised her to contact the fire department. The fire department walked the unit with all parties present, doing safety checks and explaining what the danger was and what the resident needed to do to rectify the cause. They scheduled a return visit 45 days later. In the interim, Evans reached out to her local senior center to help the photographer with organizing his materials. The photographer took advantage of this help and was able to return his apartment to satisfactory condition in time for the fire department’s reinspection.

“This particular resident still had his wits about him and, while scared about losing his life’s work, he realized he had to comply and get his home in order,” said Evans. “I think having the fire department come really helped to make him see that it wasn’t the management team enforcing a rule or being unsympathetic but gave credibility to the potential danger of the situation.”

How to Handle Evictions

Evans was able to achieve a win-win scenario for all parties by proceeding with caution and compassion, enlisting all available resources to achieve resident cooperation. But what if the resident resists all such efforts? What if health and safety risks remain elevated? What if eviction remains the only solution? Again, property managers are advised to seek legal guidance. They must fully document the process leading up to eviction, including lease-vio- lation notices, inspection reports, videos, photos and notes taken. They must retain all communications with the resident and their own history of helpful attempts, plus any direct or indirect offers of community assistance (i.e., yard cleanup, junk removal, free dumpsters, community yard sales, etc.) They must cite specific lease violations—not the hoarding itself—to avoid any appearance of unlawful discrimination. After eviction, they may need to call in a hoarding cleanup service to sanitize the entire unit and return it to a habitable state.

There remain options short of eviction. Property managers should attempt to discern between general clutter and messiness versus severe hoarding situations that require action. They should query if there are extenuating circumstances responsible for what may be a temporary situation. For example, the resident may be in process of moving or