The Five Levels of Hoarding
Hoarding is a type of obsessive compulsive disorder in which a person is unable to get rid of items even though they are useless, because doing so will cause anxiety. According to the National Study Group on Chronic Disorganization (NSGCD), there are five levels of hoarding that are outlined by the NSGCD Clutter-Hoarding Scale. Each level is defined according to several parameters, including:
- condition of the building
- number of pets and how well they are being cared for
- presence of pests such as rodents or insects
- whether or not the rooms of the residence are usable
- accessibility of doors, hallways and staircases
- sanitation and cleanliness of the residence
Level I- A normal or standard house with accessible doors and stairways, minor evidence of pet accidents, a slight presence of insects or rodents, some clutter but not excessive, and normal safe sanitation with no odors.
Level II- One of the exits is blocked, and one major appliance, heater or air conditioner has not worked for more than six months; there is pet odor and pet waste, limited care of fish, reptiles or birds, and moderate evidence of insects and rodents. The use of more than 2 of the rooms is prevented by clutter, and passageways are somewhat narrowed. There is little evidence of house cleaning activity such as sweeping or vacuuming, and moderate amounts of mildew in kitchens and bathrooms. Food preparation surfaces are soiled, garbage cans overflowing, and there are noticeable odors.
Level III- Clutter is seen outside the house, there are at least two non-functioning appliances, unsafe use of extension cords, and slight structural damage to the house. One to three pets exceeds limits set by the Humane Society (not counting litters of puppies or kittens that are being well taken care of.) There are unmaintained aquariums or bird cages, audible evidence of rodents, an infestation of fleas, and moderate amounts of spider webs. Hallways and stairs are constricted, and one bedroom or bathroom is unusable due to clutter. Hazardous substances such as broken glass or spilled chemicals are present. The house has not been cleaned and there is dust, obviously unchanged bed linens, excessively soiled surfaces, garbage and dirty laundry throughout the house.
Level IV- The house has structural damage, mold and mildew, damaged walls, electrical hazards and a backed-up sewer system. Four animals exceed Humane Society limits, and there is animal waste, pet dander, spider webs, and evidence of wild animals such as squirrels, bats or raccoons inside the house, as well as an infestation of fleas and lice. The occupants are unable to use the bedrooms, and are sleeping on the couch or floor. There are hazardous materials and flammable material in the living area. No clean dishes can be found, and there is rotting food in the kitchen.
Level V- The house is basically unlivable. There is structural damage, no water, power or sewer, standing water, and excessive hazardous materials being stored. Obvious rodent and insect infestations are present, the bathroom and kitchen are unusable, the occupant is not sleeping in the house, and there is human waste and rotten food present.
These definitions of the levels of hoarding are helpful for professional organizers and mental health professionals or social workers to determine what type of intervention or treatment is appropriate.