Suggestions from various sources

From Anxiety Care, UK:
http://www.anxietycare.org.uk/docs/hoarding.asp
Someone helping a hoarder, particularly when this is a family member, must be ready to work within the hoarder's reality not his/her own. That is, trying to apply normal logic endlessly, assuming that this person will 'see the light' if one simply keeps saying the same thing often enough, is likely simply to upset this person and

From Servicenet, in Massachusetts:
http://www.servicenetinc.org/index.php?id=148
How do you help someone who resists getting help?

Frequently, people with problematic hoarding behavior refuse help. It is tempting for concerned neighbors, friends and family to suggest that redundant articles are given away and useless ones thrown away. However, researchers have found that it is often more effective to focus on sorting possessions before suggesting removal of items. The de-cluttering process can be extremely slow and labor-intensive and is best accomplished if the person with the hoarding problem is able to maintain a sense of control. A few motivational techniques proven to be useful include:

-Discussions about the daily functions that can’t be carried out because of the clutter
-Breaking down larger tasks into manageable small areas
-Choosing target areas so progress is apparent

Since de-cluttering is likely to be extremely stressful, it is important to provide emotional support and encourage open communication about the emotional difficulties experienced during de-cluttering. It may be useful to enlist the assistance of a professional, such as a social worker or psychologist, who has had experience in dealing with people who have hoarding problems.

From Senior Sense, University of Georgia Extension
http://www.fcs.uga.edu/pubs/current/CHFD-E-47.html
How can you help a neighbor or relative who hoards? There is no quick solution. Caring friends must balance the hoarder's right to privacy against the need to protect them, as well as the respect for freedom versus safety. Most hoarders are lucid enough to understand consent documents that would permit caregivers to step in, and the hoarders often refuse to sign away these rights.

The best approach seems to be slowly establishing a trusting relationship with the hoarder. Make regular home visits that do not immediately address the hoarding problem, but instead enable you to get to know the person and his or her interests. As the relationship grows, the hoarder may be more willing to accept simple offers of assistance. Be sensitive to the fact that the hoarder finds some security in the mess that surrounds him. If you begin clearing without his support, it will only accumulate again.

Some hoarders will not respond even to careful efforts to gain their confidence. They have grown suspicious of others, sometimes justifiably. Dementia often robs a person of her ability to relate to or trust anyone. In these cases, senior service or health care agencies may have to step in to protect the senior. As a friend, your role may become one of helping the senior consider various new care options and selecting the one best suited to his situation.


From Sacramento Magazine:
http://www.sacmag.com/media/Sacramento-Magazine/October-2006/Health-When-Too-Much-Is-Not-Enough/

While they have learned more about the syndrome, adult protective services officials and code enforcement officers acknowledge that they don’t have the resources to provide the case management services that many hoarders need. And, they say, many people who hoard don’t want help.

“Even if we had all the resources in the world, you’re dealing with individuals who might not be amenable to seeking help,” says Debra Morrow, program manager for Sacramento County Adult Protective Services.

For those who do want to change, according to Graff and others, family or friends can help by getting them a diagnostic evaluation, driving them to appointments and prodding them to take the small steps needed to start clearing their clutter away.

“In the end, it’s really hands-on assistance that they need,” Graff says.

Helping Someone Who Hoards
Experts who treat and work with people who hoard say it’s best to:
• Encourage the person to get a thorough diagnostic evaluation. In some cases, people who hoard also have serious conditions such as Alzheimer’s disease, dementia, schizophrenia or a personality disorder.
• Relay concerns independently to a psychiatrist or psychologist because the patient may not be forthcoming about the problem.
• Consider individual or group therapy by someone with experience in hoarding.
• Help the person get to therapy appointments on time and follow through with treatment. Those who treat hoarders say they are often late and distractible.
• Find a friend, relative, professional organizer or coach to help the patient begin removing his or her things rather than discarding items for the hoarder.
• Offer praise for small steps and know that it will take a long time to get rid of hoarded items.