Understanding hoarding without judgment
The American Psychiatric Association recognizes hoarding disorder as a mental-health condition involving persistent difficulty discarding possessions, clutter that makes living areas hard to use, and real distress. APA estimates it affects about 2.6 percent of people. It is not laziness and it is not a character flaw.
We are not clinicians and we do not diagnose anyone. Whatever the reason a home reached its current state, our job is to make it safer and cleaner while treating the person who lives there with dignity.
Some of the homes we see involve hoarding disorder. Others are the result of illness, grief, disability, aging or a period when life simply became too much. Calls come from families, from landlords facing a rental unit, and occasionally from business owners with a packed storage room or office. Where the issue is severe sanitation rather than volume, see squalor and gross filth cleanup. The approach is the same: listen first, explain clearly and let the people involved make the decisions about their own belongings.
When outside help makes sense
Families often call after a fall, a hospital stay or a visit that revealed more than they expected. Others have known about the situation for years and have finally found a moment when the person is ready to accept help. Landlords call after a unit inspection or move-out. Adult protective services workers, guardians and attorneys sometimes reach out on a client's behalf.
Mayo Clinic lists falls, fire hazards, unsanitary conditions, family conflict and legal problems, including possible eviction, among the complications hoarding can bring. When any of those are present, or when there is spoiled food, human or animal waste, pests or water damage under the clutter, a professional cleanup is usually the safer route.
- Paths are blocked, or exits and stairs cannot be used safely
- Kitchens or bathrooms cannot be used for their purpose
- There is visible mold, rot, waste or a strong ammonia odor
- Rodents, insects or animals are living in the clutter
- A deadline, such as a sale, lease end or inspection, is approaching
How a hoarding cleanup unfolds
- Private conversation We start with a phone call or visit to understand the home, the people involved and any deadlines. Nothing is decided without you.
- Plan and safety setup We agree on which rooms come first, what categories of items to keep, and where kept items will go. The crew sets up protective equipment and clear walkways.
- Sort together Belongings are sorted into keep, donate and discard groups, with the resident or family making the calls. We watch for documents, photos, cash, jewelry and keepsakes, and set aside any medications so the family can take them to a drug take-back location.
- Remove waste and hazards Spoiled food, trash, soiled materials and contaminated items are bagged and removed for appropriate disposal.
- Clean and disinfect Once rooms are clear, surfaces are cleaned and then treated with EPA-registered disinfectants used per label directions. Odor sources are removed rather than covered up.
- Walk through and hand off We review each room with you and note any repairs, pest problems or other issues for the right professionals.
Health and safety inside a hoarded home
The risks are usually practical: tripping and falling, items that can shift or collapse, blocked exits and materials that could feed a fire. Under the clutter we may also find rodent droppings, insect activity, animal waste or water damage.
Where rodents have been active, we follow CDC guidance not to sweep or vacuum droppings and nests, because stirring up fresh rodent material can release hantavirus into the air. Our crew wears protective equipment suited to what we find, and we stop and reassess if conditions change. Heavy stacks are taken down from the top, never pulled from the bottom, and we keep at least one exit clear throughout the work.
We avoid promising that a home will be sterile or problem-free. What we can say is that waste and contaminated materials were removed, and surfaces were cleaned and disinfected with registered products used as directed.
Respecting the person who lives there
Forced, all-at-once cleanouts can be deeply upsetting, and APA notes that cognitive behavioral therapy is an established treatment for hoarding disorder. A cleanup is not treatment. We encourage families to involve a mental-health professional where possible, and we are happy to work alongside a therapist's plan.
We do not throw things away behind anyone's back. If the resident is present, they decide. If they are not, the family member, guardian or owner who authorized the work decides, and we confirm the rules in writing before we start.
Small choices help too. We ask before opening drawers or boxes, explain what we are about to move, and take breaks when a resident needs one. Progress that the person feels part of tends to last longer than progress imposed on them.
What other professionals handle
- Mental-health care and counseling go to qualified therapists and clinicians.
- Live animals in an animal hoarding situation go to their owner, a rescue or animal control before we begin.
- Trapping, baiting and pesticide treatment go to a pest control company holding a Tennessee Department of Agriculture charter.
- Electrical, plumbing, roofing and structural repairs go to qualified contractors; Tennessee requires a state contractor license for projects of $25,000 or more.
- Questions about leases, eviction or guardianship go to an attorney.
Cost, insurance and getting started
Every hoarding job is different, so we explain the scope before work starts and adjust as rooms open up. Homeowners policies frequently exclude hoarding-related conditions, although a specific event such as a sewage backup inside the home may be treated differently. Check with your insurer or agent before assuming either way.
You can reach us at 615-513-5112 day or night, or write to contact@nashville247biohazardmanagement.com. We work across all 41 counties of Middle Tennessee. For specific situations, see animal hoarding cleanup, estate cleanouts or our page on insurance and biohazard cleanup.
Specialized hoarding cleanup services
- Animal Hoarding Cleanup — Cleanup after animal hoarding: feces, urine-soaked carpet, pad, drywall and subfloor treatment, disinfection and odor-source removal once animals are rehomed.
- Gross Filth Cleanup — Deep biohazard cleaning for homes in squalor, including rotting food, human and animal waste, soiled materials, pests and odor sources.
- Hoarding Pest Infestation — Hoarding cleanup where rodents, roaches or bed bugs are present, timed with a chartered pest control provider, including wet removal of droppings and nests.
- Estate Hoarding Cleanout — Cleanouts of hoarded homes for executors, heirs and attorneys, with careful searches for documents and valuables, biohazard cleanup and deep cleaning.
- Rental Hoarding Cleanout — Hoarding cleanouts of apartments, houses and condos for landlords and managers, with trash-out, biohazard and pest cleanup, deodorizing and before-and-after photos.