Adult Son Comforting Father Suffering With Dementia

Levels of hoarding

Although not commonly used by clinical psychologists, criteria for five levels of hoarding have been set forth by the Nationa Study Group On Chronic Disorganization (NSGCD) entitled the NGSCD Clutter Hoarding Scale. Using the perspective of a professional organizer, this scale distinguishes five levels of hoarding with Level 1 being the least severe and Level 5 being the worst. Within each level, there are four specific categories which define the severity of clutter and hoarding potential:

  • Structure and zoning;
  • Pets and rodents;
  • Household functions; and
  • Sanitation and cleanliness.

 Level 1 Hoarder

Considered to be an average household where no professional knowledge of Chronic Disorganization is required. Average signs of clutter where no rooms or exits are blocked. All pets are properly maintained. Some evidence of pet accidents. Small presence of pests and rodents. No odors, or sanitation issues.

 Level 2 Hoarder

This household requires reorganization and some knowledge of Chronic Disorganization. Moderate clutter blocks access to one exit. One appliance (refrigerator, stove, washer, dryer, heater, air conditioner, etc.) has not functioned for six months. Pets are not being properly maintained, their environments not cleaned, and evidence of pet waste in the home. One to two rooms cannot be properly used due to clutter.  Little evidence of any cleaning in the home, kitchen waste can be seen in the kitchen, and food preparation surfaces are contaminated. Moderate evidence of pests and rodents and foul odors are present.

 Level 3 Hoarder

Enough clutter exists inside to be seen outside of the home. Unsafe conditions exist such as precariously stacked objects, improper use of extension cords, and chemical hazards. Structural damage to the home can be seen. At least two appliances are not functioning. A household may require services in addition to those a professional organizer and related professional can provide. Professional organizers and related professionals working with Level III households should have significant training in Chronic Disorganization and have developed a helpful community network of resources, especially mental health providers.

 Level 4 Hoarder

Household needs the help of a professional organizer and a coordinated team of service providers. Psychological, medical issues or financial hardships are generally involved. Resources will be necessary to bring a household to a functional level. These services may include pest control services, "crime scene cleaners," financial counseling and licensed contractors and handypersons.

 Level 5 Hoarder

The household will require intervention from a wide range of agencies. Professional organizers should not venture directly into working solo with this type of household. The Level V household may be under the care of a conservator or be an inherited estate of a mentally ill individual. Assistance is needed from many sources. A team needs to be assembled. Members of the team should be identified before beginning additional work. These members may include social services and psychological/mental health representative (not applicable if inherited estate), conservator/trustee, building and zoning, fire and safety, landlord, legal aid and/or legal representatives. A written strategy needs to be outlined and contractual agreements made before proceeding.