5 Stages of Hoarding Explained

Hoarding is a serious condition that involves the obsessive collection of personal items or trash because there is a perceived need to keep them. Emotional, physical, financial and legal consequences can result from this irrational compulsion to save and store things of no real value. These consequences not only affect the hoarder but have rippling consequences for all the people in the hoarder’s life.

The National Study on Compulsive Disorganization developed a scale to define the levels of hoarding to help professionals and family members understand the hoarding situations with which they are confronted.

There are 5 stages of hoarding with progressive stages being more severe than the previous. The 5 stages of hoarding are:

  • Level 1: The Least Severe Level with Few Indicators
  • Level 2: Noticeable Object Collection and Embarrassment with Visitors
  • Level 3: Odors, Poor Hygiene, and Narrowed Hallways
  • Level 4: Structural Damage, Sewage Issues, and Unusable Rooms
  • Level 5: Fire Hazards, No Electricity or Running Water and Accumulated Human Feces


Level 1: The Least Severe Level with Few Indicators

This is the least severe level of hoarding, but it goes beyond simple collecting because objects and belongings are not organized and displayed. There are few indicators that this level of hoarding is occurring because the condition may be hidden due to a lack of visible clutter, although most appropriate storage areas in the house are jam packed with items. Cabinets, closets, storage sheds and bookshelves are filled to the max. The individual that is a level 1 hoarder finds throwing items away difficult and does an unreasonable amount of shopping for items that are not needed. A level 1 situation may appear as follows:

  • Light clutter
  • No noticeable odors
  • All doorways and staircases are accessible
  • No more than three areas with managed animal waste throughout the home


Level 1


Level 2: Noticeable Object Collection and Embarrassment with Visitors

When a hoarder has reached level 2, they begin avoiding visitors due to embarrassment, stress or anxiety regarding their hoarded items. This level is when typical hoarding characteristics start to become noticeable. Signs that a hoarder has reached level 2 include:

  • At least one blocked exit
  • One major appliance is out of order
  • The ventilation system has been malfunctioning for at least six months creating rooms with no cooling or heating due to clutter
  • Clutter has accumulated in walkways and is noticeably excessive in one or more rooms
  • There is limited housekeeping due to inaccessibility, and light mildew exists in bathrooms or kitchens


Level 3: Odors, Poor Hygiene and Narrowed Hallways

At this level, hoarders typically have very poor personal hygiene and are suffering from emotional distress. These two situations often contribute to weight control issues. A level 3 hoarder will become extremely defensive of their living situation when confronted and often rationalizes their living situation because they cannot see the dangers present within their home. Level 3 hoarding can include the following:

  • Clutter and household items accumulating outside of the home
  • Two or more household appliances have been in disrepair for six months
  • One area of the home shows light structural damage
  • There is an excessive number of pets
  • Living spaces have been neglected and cannot be tidied up
  • A visible rodent, flea or spider infestation
  • Narrowed hallways
  • At least one unusable bedroom or bathroom
  • Accumulation of excessive dust and dirty clothing
  • Extremely soiled flooring
  • Noticeable odors exist in the home


Level 4: Structural Damage, Sewage Issues and Unusable Rooms

Individuals that have reached this level of hoarding often go weeks without bathing. They usually are suffering from a mental health crisis and cannot see that their situation is dangerous or unsanitary. Signs that level 4 hoarding is occurring are:

  • Noticeable mold and mildew throughout the home
  • Structural damage to the home that is at least six months old
  • Sewage issues
  • At least three areas with excessive and aging animal waste
  • Multiple rooms have become unusable
  • Spoiled and rotting food in kitchen areas
  • Fleas, lice, bed bugs and other major pest infestations
  • More than one exit is blocked


Level 5: Fire Hazards, No Electricity or Running Water and Accumulated Human Feces

This is the most severe type of hoarding, and individuals at this level may not be able to live in their own home, nor can their home be salvaged for future habitation. Human and animal waste is often collected in containers that cannot be disposed of down the toilet yet remain in and around the home. Level 5 hoarding situations often meet the following criteria:

  • Severe structural damage to the home
  • Broken or crumbling walls
  • Major fire hazards throughout the home such as paper accumulation around open flames
  • No electricity or running water due to neglect
  • Clutter on every surface, hallway and floorspace
  • A noticeable accumulation of human and animal feces
  • Most spaces in the home are inaccessible


The Effects of Hoarding

The effects of hoarding go beyond the mess that has arisen. As a hoarder progresses through the levels of hoarding, there are serious safety concerns regarding sanitation and safety. Not only are the hoarders themselves a victim in these situations, the loved ones and neighbors of the hoarder are as well. While hoarding can impact all ages and demographics, it is often seen in older individuals.

In severe cases, individuals become reclusive and isolate themselves from friends and family. Unintended death can result from the unsafe conditions created by a hoarding situation. While the hoarding levels presented help to identify different levels of severity inherent in the condition, each person’s specific situation will be different. Hoarding is serious, and it must be handled in the right way.

At Spaulding Decon, our trained biohazard remediation professionals know how to clean up a hoarder’s home and we understand the emotional attachment that exists to the belongings.

Our teams can create custom cleanup plans while working with mental health professionals to ensure that your loved ones get the help and support they need during the difficult cleanup process.

Levels of Hoarding Links

  1. Level 1 Hoarding Explained
  2. Level 2 Hoarding Explained
  3. Level 3 Hoarding Explained
  4. Level 4 Hoarding Explained
  5. Level 5 Hoarding Explained

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