The Institute for Challenging Disorganization, or ICD, created the Clutter-Hoarding Scale to be used as a tool to assess residential environments in regard to the level or extent of hoarding that may exist in the premises. The Clutter-Hoarding Scale is designed for residential assessments only.
Five Levels of the Clutter-Hoarding Scale
The Clutter-Hoarding Scale is organized into five levels to indicate the level of household clutter. In addition, each of these levels includes five assessment categories to assist in analyzing the nature and extent of clutter in a household.
The levels utilized in the Clutter-Hoarding Scale are:
- Level I – Green – Low
- Level II – Blue – Guarded
- Level III – Yellow – Elevated
- Level IV – Orange – High
- Level V – Red – Severe
The levels are progressive, with Level I at the bottom of the spectrum. Level III represents what might best be called the pivot point in the spectrum. It is on this level that a consideration needs to be made as to whether the issue at hand is household clutter or perhaps the beginnings of a hoarding environment.
Five Assessment Categories
As mentioned previously, each of the five levels utilized five individual assessment categories to ascertain the status of residential property in regard to clutter or hoarding. The same assessment categories are utilized in each of the five levels. The assessment categories are:
Structure and Zoning
The assessment includes an evaluation of the accessibility of entrances and exits into the residence. The assessment also includes an evaluation of the functionality of plumbing, electrical, and HVAC systems. The functionality of appliances is also analyzed. Finally, the assessment category also takes into account the overall structural integrity of a residence.
Animals and Pets
The assessment considers overall animal care and control. This consideration includes compliance with any applicable animal regulations. An exploration of any evidenced of pest infestation also occurs. This includes a determination of whether any rodents, insects or other vermin are found in the premises.
The household function assessment involves a consideration of the accessibility, functionality, and safety of the residence itself. The assessment includes an evaluation as to whether or not the rooms are utilized for intended purposes.
Health and Safety
The health and safety assessment involves an evaluation of the sanitation levels of the residence. It also includes an assessment of the management of medications, including prescription and over-the-counter drugs.
Personal Protective Equipment
Finally, the fifth assessment involves any recommendations for personal protective equipment that might be needed to address clutter, or hoarding, issues in a residence. For example, are personal protective equipment items like eye shields, face masks, or specialized clothing necessary to protect a person from safety hazards or environmental health dangers.
Clutter-Hoarding Scale Levels
At Level I, the household environment is considered standard. There are no extraordinary issues in the residence that require special consideration. No special knowledge is required to assisting or dealing with a chronically disorganized individual in a residence rated at Level I.
Door, stairways, and windows appropriately are accessible. Animal control is evident, both as to behavior and sanitation. There exists no excessive clutter and sanitation is appropriately maintained. Personal protective equipment is not necessary to assist a chronically disorganized person in this type of setting.
At Level II, the household environment is in such a state that professional assistance is needed. Individuals with additional knowledge and understanding associated with chronic disorganization need to be retained. Although the residential situation doesn’t rise to the level of hoarding, there are significant issues that need to be addressed.
One major exit is blocked at the residence. In addition, a major appliance or the HVAC system have not been working properly for at least one season. Electrical or plumbing may not be fully operational.
Evidence exists of inappropriate animal control. This can be related to animal behavior, sanitation, or both. Visible or odorous pet waste is evident as is pet fur. There is also likely to be insects or other vermin in the residence.
Clutter obstructs some, but not all, of the living areas. There are no established routines associated with house cleaning let alone maintenance.
There is also evidence of inadequate sanitation. There will be odors associated with dirty dishes, unwashed clothing, and an unclean toilet. In additions, medications are not properly organized or stored.
Some light personal protective equipment is recommended for a person involved in remediating the situation in a residence classified at this level. This is likely to include medical or industrial grade latex or nitrile gloves and heavy-duty leather or cloth work gloves with reinforced palm. In addition, caps and disposable shoe covers may also be in order.
As noted earlier, Level III represents the pivot point at which a person may be classified as afflicted with a hoarding disorder based on the state of the residence. Professional assistance is needed at this level. The types of professionals that may be necessary to address a Level III situation include individuals with a network of resources. This network needs to include mental health professionals.
Clutter has extended beyond the walls of the residence. There are items typically found in a residence left outside of the structure. HVAC devices have not been functioning for longer than one season. There is likely some damage to the residential structure.
The population of animals at the residence exceeds legal limits. There is inadequate animal sanitation and the animals exhibit control issues. There is at least a light insect infestation at the premises. There may be problems with other vermin at the residence as well.
Clutter prevents the functionality of key areas in the residence. Several appliances do not function properly. Smaller hazards exist on the premises, like broken glass.
Evidence of unsanitary conditions exist. This can include heavily soiled food preparation surfaces, dirty dishes, and dirty toilets. There are obvious odors. Trash cans are overflowing or not in use at all.
Dirty laundry is scattered throughout the house. Medications are not properly stored.
The need for medium personal protective equipment exists in this type of environment. This equipment includes face masks, eye protection, gloves, disposable clothing covering, shoe covers, and caps.
The situation at the residence has become serious. At Level IV, the residence necessitates a coordinated, collaborative team of professional service providers, together with family members or other supportive individuals. The collaborative team is likely to include mental health professionals, social workers, financial counselors, pest and animal control officers, licensed contractors and handypersons. There likely to be mental health and financial issues playing into the situation at the residence.
At Level IV, there tends to be excessive exterior clutter, which includes items normally found inside a residence. HVAC devices have not functioned for over a year. There exists structural damage to the premises. There very well may be sewer-related problems, exhibited by odors.
The animal population exceeds legal maximums. The animals at the premises engage in destructive behavior. Animals like rodents live in the basement, walls, or attic. There is a medium level if insect infestation that may include fleas, bedbugs, lice, or cockroaches.
There is a diminished use of key living areas. In fact, more than one room cannot be used at all for its intended purpose.
There exists rotting food at the premises. Dishes and utensils are not usable. Beds lack linens and residents are likely sleeping on mattresses on the floor. Medications are not properly stored.
Full personal protective equipment is necessary to remediate the situation at a Level IV resident. This includes face masks, safety goggles, and all manner of protective clothing as previously described at Level III.
The residential situation at Level V is severe. This is the residence of a hoarder. A layperson is likely to consider the situation in a Level V residence as catastrophic. The residential environment requires intervention from a broad spectrum of professionals. They must operate as a team. These professionals likely include mental health professionals, social workers, building manager, zoning, fire, and/or safety agents. If at all possible, family and friends need to be involved in the remediation process as well. A person living in a Level V residence likely experienced mental health, financial, and legal issues.
Extreme interior and exterior clutter exist. There likely is not ventilation into the premises and HVAC systems do not function. The plumbing, electrical, and sewage systems are unreliable. Pervasive odors exist at the premises.
Animals are at risk, both to themselves and to humans, because of their numbers, behavior, and health. There exist pervasive vermin and insect infestation at the residence.
Key living spaces are not usable. Indeed, most of the rooms in the residence are likely unusable and perhaps even unpassable. Toilets, sinks, and bathtubs are not functioning.
Rotting food is present on the premises, together with human excrement. Beds are unusable due to clutter, infestation, or both. Dishes and utensils are unusable or even nonexistent.
Full personal protective equipment is required for a person involved in the remediation of the situation in a Level V residence. This is the equipment set forth in Levels III and IV.
In the final analysis, addressing a situation involving hoarding, or even less severe chronic disorganization, requires access to professionals of different types. The situation requires appropriate, comprehensive remediation assistance. In addition, a person suffering from chronic disorganization or hoarding needs resources, support, and assistance going forward to prevent a repeat of problems and issues in the future.