In extreme cases, some keep "empty matchbooks, used tissues, old cigarette butts, bird feathers, old cars, discarded paper cups, used aluminum foil, paper towels, lint, and hairs," the Website said. Some have even rummaged through other people's garbage and pick out items that to them seems quite useful or repairable.

Storage problems, health, and fire hazards result from hoarding, such as the inability to leave the home quickly in case of fire or other emergencies, not being able to find a fire extinguisher, and blocked doorways, the Website said.

Compulsive hoarders often feel distressed about their situation and show signs of indecisiveness, procrastination, and avoidance. An estimated 700,000 to 1.4 million people in the United States are thought to have compulsive hoarding syndrome, the Website said.

This kind of hoarding is not about someone collecting stamps or baseball cards. Dr. Randy Frost and his colleagues provides the following guidelines to differentiate from "normal" collecting from compulsive hoarding.

• Compulsive hoarders have an obsessive need to acquire and save many objects, and tremendous anxiety about discarding them, because of a perceived need for the objects for their apparent value or an excessive emotional attachment to them. A compulsive hoarder will think, "This is too good to throw away," "This is important information," "I will need this later on," "This should not be wasted." These thoughts are generally normal, but their frequency and the importance attached to them are clearly excessive.

• Living spaces are so cluttered there is no room for activities the space was designed for. Lots of items are coming into the home and very few going out. The clutter spreads onto the floors, counter tops, hallways, stairwells, garage, and cars. There is no room to sleep on beds and chairs are buried under piles so there is nowhere to sit. Food cannot be prepared on kitchen counters anymore. It can get to the point only a narrow pathway connects each room, and the rest of the house is piled several feet high with clutter.

• Distress or impaired functioning is felt by the hoarder. Compulsive hoarders frequently take a long time to do even small chores because of a desire for perfection. Many have limited social interactions and become embarrassed by their clutter. "A survey of elderly hoarders found that hoarding constituted a physical health threat in 81 percent of dentified cases, including threat of fire hazard, falling, unsanitary conditions, and inability to prepare food," the Website reads.

In "How Compulsive Hoarding Affects Families," Dr. Fugen Neziroglu writes, "Clutter is one of the biggest contributors to family tension with regards to homes with hoarders....

Decreased or eliminated functional living space may mean that families are not able to use their kitchens to cook food and may, therefore, be dependent on ordering take out regularly. This can often lead to increased financial strain and obesity, because they are spending more money and taking in more calories than they would if they were grocery shopping and cooking."

He also said "the spilling of liquids, such as, soda, juice and water are often not cleaned up and cause mildew or fungus. Combined with the high levels of dust being inhaled, this mildew and fungus can significantly complicate the health of the family of the compulsive hoarder.

"Sometimes cats are not able to find or enter litter boxes, or dogs are unable to 'hold it' long enough for owners to maneuver through clutter. Both situations result in the animals urinating or defecating inside the home, sometimes unknown to the family. This combined with the mildew and possible fungus that results from spilled liquids and possibly decaying floorboards can often attract rats, cockroaches and other uninvited guests," Dr. Fugen wrote.

"It is essential to educate family members and loved ones," according to Karron Maidment, a behavior therapist who specializes in OCD treatments. "They need to learn how to support the compulsive hoarder without enabling them . . . Also, the public and the relevant social service organizations need general education about this terribly disabling syndrome."

Kienzle has arranged for Karron Maidment to put on an all-day training seminar for those who work in the health and safety field and want to help compulsive hoarders. Maidment is the program coordinator for the Obsessive Compulsive Disorder Intensive Treatment Program at the University of California Los Angeles (UCLA) Neuropsychiatric Institute.

"Our director Phyllis Murdock of Public Health said she would make sure we got the funding for it, and she did. We are working in conjunction with the departments of Social Services and Behavior Health in putting on a seminar with Maidment as our speaker in October at the Southside Community Center," Kienzle said.

Housing officials, medical professions, home visitors, emergency medical technicians and responders, mental health professionals, legal services, law enforcement, and social workers will gather for a full day's training on "Compulsive Hoarding: Partnerships for Successful Treatment Outcomes."

At this time, the conference is for those in positions of working with and providing services to compulsive hoarders, but might have some open seating for the public if there is any available seating after registration.

Code Enforcement issues will also be addressed at the conference, such as housing and habitability with compulsive hoarders and how cities and counties enforce laws and regulation affecting hoarders.

"We want to develop a practical approach for dealing with this disease," Kienzle said. "We also hope to network with faith-based groups to help, too," she added.

Therapist Tim Quinn and Bill Miller from the Adult Services Division along with Craig Erickson of Butte County Animal Control are also working on this issue with the health departments.

For more information, call Alice Kienzle at Butte County Public Health at: (530) 538-7831. Also, see the Compulsive Hoarding Website at: www.ocfoundation.org/hoarding, or www.tufts.edu/cfa/hording

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