He feels his way along a wall. Thick black smoke creates total darkness. Tugging at the water hose, heavy and awkward, the firefighter snakes forward to the point of the flames.

Suddenly, behind him, a stack of clothing or newspapers falls. The path he took in from the front door is blocked. He'll have to find another way out.

A window? Another door?

That's the danger and the dilemma firefighters encounter when they enter a home stacked high with stuff, said Daryl Giles, assistant fire marshal for the Omaha Fire Department.

Clutter in its mildest sense means a few too many figurines on the mantel, a few too many jackets thrown over a chair and perhaps some family tiffs about getting rid of stuff.

When clutter becomes serious hoarding, though, dwellings become difficult to navigate. It raises mental health and public health issues and becomes a potential nightmare for firefighters.

"We do encounter hoarding on occasion," Giles said, "and it may not be evident from the street," where the fire crew assesses the location of the flames and rescue needs.

A fire blamed on faulty wiring killed three people in Fremont, Neb., last week. And clutter hampered firefighters from the moment they arrived, just minutes after receiving the alarm.

"The front door couldn't swing open," said Capt. Jamie Meyer of the Fremont Fire Department.

Kevin Denker, Omaha's chief code inspector, said somebody usually reports a hoarder - maybe the mail carrier or a visiting nurse - or the outside of the house shows hints of the overflow inside.

"Sometimes you can guess because the curtains or blinds are pressed against the windows," he said.

Boxing or storing items that aren't being used usually can solve clutter. But hoarding is clutter times 10. It represents way more stuff than anyone could use at a given time, maybe stacks of containers, newspapers, magazines, unopened purchases and clothing. Sometimes hoarders collect animals.

Even a professional organizer can't take on a hoarder alone.

"Hoarding is a mental health problem," said Suzette Gavin of An Organized Life, an Omaha business that organizes homes.

A professional organizer might be able to help with the immediate problem, but engaging a mental health professional is equally important.

The National Study Group on Chronic Disorganization, a spinoff of the National Association of Professional Organizers, drew up a Clutter Hoarding Scale to help people determine the difference between mild clutter and serious hoarding.

Tackling clutter often can be a matter of setting up three areas in each room or work space, one for give-aways, one for garage sale and one for trash. The HGTV show "Mission Organization" took that approach to help homeowners pare down their possessions.

But at the most extreme level, hoarders need the intervention of a range of agencies, possibly including social services, fire and safety departments, humane society, building and zoning departments, the landlord, family and legal representatives.

Hoarders tend to feel overwhelmed or embarrassed about their plight and may resist seeking help. Or they may be in denial.

Denker recalled a case from a few years ago.

"There was a woman who had stacks of things piled 3 feet high in this 1,000-square-foot house. We got her help to clean it out. Three years later, we were back. We try to encourage counseling with all of them."

When jumble rises to peril

Professional organizers use the Clutter Hoarding Scale to assess a home, examining four categories: structure and zoning; pets and rodents; household functions; and sanitation and cleanliness. Among the criteria:

Level 1: Doors and stairways accessible; normal pet activity; light evidence of insects or rodents; clutter not excessive; normal housekeeping, safe and healthy sanitation, no odors.

Level 2: One exit blocked; one major appliance or part of the heating and cooling system not working for six months or more; some pet odor; light to medium evidence of rodents or insects; clutter inhibits use of more than two rooms; narrowing of household pathways; limited housekeeping; overflowing garbage cans; mildew in bathroom or kitchen; soiled food preparation areas.

Level 3: Visible clutter outdoors; indoor items placed outdoors (TV, sofa); two or more broken appliances; inappropriate or excessive use of electric cords; light structural damage to part of home; more pets than humane society recommends; audible but not visible evidence of rodents; light flea infestation; spider webs; narrowed hall and stair; one bathroom or bedroom not fully usable.

Level 4: Mold, mildew, structural damage, hazardous wiring; excessive number of pets, flea infestation, aged animal waste, pet damage; designated bedroom unusable; hazardous materials stored indoors; combustible materials in living area or attached garage; aged canned goods; no bedding; lice on bedding or furnishings; no clean dishes.

Level 5: Structural damage; no electricity or water service; standing water in basement; hazardous materials storage exceeding local limits; pets dangerous to occupants; rodents in sight; mosquito or insect infestation; critter infestation (bats, raccoons, snakes); kitchen and bathroom unusable due to clutter; client sleeping elsewhere; human defecation; rotting food; canned goods with buckled tops and sides.

Source: The National Study Group on Chronic Disorganization