Working with People Who Hoard: Compassion, Respect and Risk
Working with someone who hoards is never just about clearing a property. Hoarding can be linked to trauma, grief, mental health, anxiety, self-neglect, disability, bereavement or life becoming overwhelming. Approaching these situations with Hoarding Compassion Caring is why a compassionate, person-centred approach is so important.
A helpful reminder from Research in Practice is that professionals need to balance respecting the person’s decisions with addressing risks alongside them. Ultimately, Hoarding Compassion Caring supports the balance between empathy and managing safety.
Why hoarding needs a careful approach
For many people, their belongings feel deeply personal. What may look like clutter to someone else can represent memories, security, identity or control. In these moments, applying compassion, caring, and hoarding sensitivity together should guide any decisions, as moving too quickly, forcing decisions or clearing without consent can cause distress and may make the situation worse.
Instead, support should be calm, respectful and paced around the person wherever possible. Remember, the right approach always involves balancing compassion, hoarding awareness, and caring for all involved.
Balancing choice and safety
When working with someone who hoards, there are often practical risks to consider, including:
- Fire hazards
- Trip and fall risks
- Blocked exits
- Poor sanitation
- Mould or damp
- Biohazard contamination
- Pest or rodent activity
- Difficulty accessing kitchens, bathrooms or bedrooms
- Risks to carers, family members or professionals entering the property
The key is to talk openly about these risks while still respecting the person’s rights, feelings and choices. As you can see, Hoarding Compassion Caring is essential for open, respectful communication in these circumstances.
Difficult conversations matter
Hoarding support often involves sensitive conversations. These may include discussions around safety, health, hospital discharge, tenancy concerns, care packages or safeguarding. Another essential element is ensuring every conversation is shaped by caring, compassion, and an understanding of hoarding.
These conversations should be handled with kindness, honesty and patience. The aim should never be to shame someone, but to work with them to make their home safer and more manageable through a foundation of hoarding-related compassion and caring attitudes.
Supporting practice: having courageous conversations | Research in Practice
How Pocket Rockets can help
At Pocket Rockets East Anglia, Essex and East London, we support people living in hoarded, cluttered or neglected properties with dignity and without judgement. With every engagement, our services are built around caring in hoarding cases, showing compassion for individuals, and addressing their unique needs.
Our team can help with:
- Hoarding support cleans
- Welfare cleans
- Hospital discharge preparation
- Biohazard cleaning
- Deep cleaning and sanitisation
- Waste removal
- Needle sweeps and sharps disposal
- Mould cleaning and treatment
- Odour removal and fogging
- Creating safe access to key rooms
- Ongoing refresh visits to help prevent relapse
We work with families, social workers, housing teams, councils, care providers, charities and private clients, always keeping compassion, hoarding expertise, and caring service at the forefront.
Case Studies – Pocket Rockets East Anglia
A person-centred clean
Every property and every person is different. Some clients need a full clearance, while others need small, steady steps to make one room safer. Sometimes the priority is creating a clean bedroom, a usable bathroom, safe access for carers or a clear route through the home. To truly make a difference, it is vital to integrate compassion, hoarding knowledge, and ongoing caring into the cleaning process.
Where possible, we work with the person, not around them. We listen, explain what we are doing and help reduce overwhelm. Our approach highlights caring, compassion and a deep understanding of hoarding challenges.
Person-centred approaches to adult mental health | Research in Practice
Final thoughts
Supporting someone who hoards takes patience, understanding and the right balance between compassion and safety. With the right approach, it is possible to reduce risk, restore dignity and help people feel more in control of their home again. It’s all about making compassion, hoarding awareness and caring actions work together for positive change.
If you are supporting someone who hoards in Essex, East London, Suffolk, Norfolk or Cambridgeshire, Pocket Rockets can help.
Contact Pocket Rockets East Anglia, Essex and East London
📞 01223 782801 / 07576 719229 / 07472 306834
📧 hello@pocketrocketseastanglia.org.uk
🌐 www.pocketrocketseastanglia.org.uk
Can a hoarded property be cleared without the person’s consent?
In most situations, support should be planned with the person’s informed agreement. A person may make choices that others consider unwise and still have the right to make those choices. Before arranging a clearance, professionals should explain the proposed work, discuss what will happen to belongings, and record the person’s preferences.
If there are concerns that the person cannot understand, retain or weigh up the relevant decision, a capacity assessment may be needed under the Mental Capacity Act 2005. Any action taken following a finding of lacking capacity must be lawful, necessary and in the person’s best interests. Immediate action may be required where there is a serious fire, health or access risk, but this should involve the appropriate housing, safeguarding, emergency or health professionals.
What does compassionate hoarding support involve?
- Initial conversation: Agree the immediate concern, such as access to a bed, toilet, kitchen, front door or care visit.
- Risk-led assessment: Identify urgent hazards including blocked escape routes, unsafe electrics, sharps, animal waste, mould, pests or unstable stacks of items.
- Small achievable goal: Start with one practical outcome rather than attempting to change the entire property in one visit.
- Sorting with the client: Where safe and practical, the person chooses what to keep, recycle, donate or remove.
- Cleaning and safe disposal: Complete agreed cleaning, waste removal, sanitisation or specialist biohazard work.
- Follow-up support: Arrange refresh visits or coordinate with family, social care, housing and health teams to reduce the likelihood of the home becoming unsafe again.
This paced approach reduces distress while dealing with the risks that matter most.
Hoarding, self-neglect and adult safeguarding
Hoarding may be considered as part of a wider self-neglect concern, particularly where the condition of a home creates significant risks to health, safety, dignity or access to care. In England, safeguarding partners work within the Care Act 2014 framework, which includes self-neglect within statutory adult safeguarding guidance.
A cleaning company is not a substitute for social care, medical treatment or a safeguarding enquiry. However, practical observations can help the right agencies understand the situation. Relevant information may include whether exits are blocked, whether carers can enter, whether the person can prepare food or use washing facilities, and whether there are signs of fire risk, infestation, damp or contamination.
With the person’s knowledge wherever possible, concerns can be shared with the local authority adult safeguarding team, housing provider, GP, social worker or care coordinator. In an immediate emergency, contact emergency services.
Using the Clutter Image Rating to discuss clutter respectfully
The Clutter Image Rating is a visual tool developed by researchers Randy O. Frost, Gail Steketee, and David F. Tolin. It uses photographs of rooms at different levels of clutter so that professionals and residents can discuss conditions without relying on subjective labels such as messy or dirty.
Used sensitively, the tool can support a shared conversation about whether a room is safe to use and which area should be addressed first. For example, a bedroom may be prioritised if there is no safe sleeping space, or a hallway if it restricts exit during a fire or prevents carers from entering.
The Clutter Image Rating should not be used to shame, diagnose or force a clearance. It is most useful when combined with the person’s own goals, a practical risk assessment and an agreed plan for gradual change.
How can families and professionals raise concerns about hoarding?
Begin with concern for the person rather than criticism of the property. Ask permission to talk and use specific observations: for example, that the bathroom cannot be reached safely or that the front door is difficult to open. Avoid threats, arguments about the value of possessions, or removing items without agreement unless there is an immediate safety reason and appropriate authority.
It can help to ask what the person wants to make easier. They may want to receive carers, sleep in their own bed, have a relative visit, prepare meals or resolve a tenancy issue. A shared goal provides a more constructive starting point than demanding a full clear-out.
For a referral, provide practical details: the rooms affected, known hazards, access arrangements, whether there are pets, whether sharps or contamination are present, and which professionals or family members are involved. This helps plan a safe and appropriately paced visit.