When It Isn’t Just Clutter Anymore

She was a retired college professor, living alone in a New York apartment that had become unmanageable. When she called Bergfeld’s Estate Clearance Service for help, Kristin Bergfeld had trouble entering the apartment; the professor had to move objects out of the way simply to open her front door.

Inside, Ms. Bergfeld found a familiar scene: a person overwhelmed by her possessions, many of them unused or useless. “You know those big plaid plastic bags people use for laundry?” she recalled. “About 100 of those, filled with teaching materials from the last 10 years. Clothing items she’d bought from catalogs, 10 of each in different colors with the price tags still on them. Lots and lots of bottles for recycling — maybe 30 large trash bags — that never made it out.”

The stuff was stacked three feet deep. In the bedroom, it reached the ceiling. The professor could no longer use her bed; she slept in a cleared space on her kitchen floor. “It’s a heart-breaker every time I see it,” Ms. Bergfeld said. “This is an intelligent, engaging person who was hugely embarrassed and ashamed.”

Hoarding — a compulsive need to acquire and inability to discard items of no apparent value, to the point where one’s ability to function becomes impaired — is a disorder that begins early in life, researchers are learning. But the symptoms appear to increase with each decade of age and so, of course, does the sheer amount of stuff amassed.

What do elders hoard? Junk mail. Plastic containers. “Newspapers are very common,” said Julie Wetherell, a psychiatry professor at the University of California, San Diego, who has written about the phenomenon. “Plastic bags from the grocery store. Some people hoard food. Or animals — the people with a hundred cats. If something is on sale at the dollar store, instead of buying three or four boxes, hoarders buy 40.”

Suggest that you clear away the clutter, as adult children often do, and a hoarder will come up with a litany of reasons to refuse: He is going to get around to reading those papers one day. The mess doesn’t bother him, so why should it bother you? It’s his home, so back off. “Hoarders are very resistant to an offer to help,” Dr. Wetherell said. “And very resentful if you try to do anything behind their backs.”

Besides, a one-time cleanup operation is only a temporary fix for this syndrome. “It’s a chronic condition,” said Catherine Ayers, Dr. Wetherell’s co-author and colleague at the university. “If you clean out the home, the person will reclutter it within six months.”

A parent’s inability to part with a collection of plastic bags or a three-year pile of catalogs, though sometimes exasperating, may not pose a serious problem. But taken to extremes, clutter can cause fires, draw rodents and roaches, and increase the risk of falling as elderly people navigate around piles of debris. “It’s a continuum,” Dr. Eric Lenze, a Washington University geriatric psychiatrist, said of hoarding. “If it’s unsafe — a fire hazard or a sanitation hazard — then it’s clearly crossed the line.”

The professor’s pattern was not uncommon; therapists who work with such patients tell about whole sections of residences becoming unusable as they silt over with stuff, leading to poor nutrition when people can no longer prepare meals or poor hygiene when they can no longer bathe. But it is such a hidden problem, invisible outside the home, that only family members may see it.

Though it strikes me as an odd form of entertainment, executives at the cable channel A&E have found the subject compelling enough to produce a show called “Hoarders” in which people struggle to gain control over their lives. I can see the potential drama, though: without help, hoarders can face social isolation, eviction, even lawsuits or action by adult protective service agencies if they’re found to be endangering their own well-being.

So it would be nice to report that there is a simple, reliable, widely available treatment. Not yet, sadly. Researchers are still unraveling this conundrum, uncertain how to classify the disorder. Though often associated with obsessive-compulsive disorder — and the Obsessive Compulsive Foundation Web site has useful information on hoarding — it appears to be a separate syndrome.

“It’s a problem we don’t have a name for or much understanding of,” Dr. Wetherell said. “And yet we all see it.” But a variant of cognitive behavioral therapy, in combination with the drugs called serotonin reuptake inhibitors, shows promise in helping people begin the painful process of discarding.

It has taken Ms. Bergfeld’s crew eight full days over several months to liberate the professor, who is also seeing a counselor and will need follow-up sessions with a professional organizer. But the encroaching rubbish is much reduced; the professor can sleep in her bedroom now.

“Once she could let somebody in and say, ‘I have a problem, can you help?,’ there was huge relief,” Ms. Bergfeld said. “I told her, ‘You’ve done the most important thing.’”

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”