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125
Health Implications of Animal Hoarding
CCC Code: 0360-7283/02 $3.00 ©2002, National Association of Social Workers
Health Implications of
Animal Hoarding
Hoarding of Animals Research Consortium (HARC)
Animal hoarding is a poorly
understood phenomenon, the public
health implications of which are not
well documented. In this study,
professionals dealing with hoarding
cases submitted 71 case report forms.
The hoarders’ residences were
characterized by extreme clutter and
poor sanitation that impaired ability
to maintain functional households.
Appliances and utilities were
frequently nonfunctional, and animal
excrement sometimes accumulated to
the extent that the homes were unfit for
human habitation. The majority of
cases satisfied criteria for adult self-
neglect, and dependent elderly people,
children, or disabled individuals were
present in many of the residences.
Animal hoarding may be a sentinel for
a range of medical, social, and
economic problems. More research
addressing the causes and features of
animal hoarding is needed to shed light
on appropriate interventions.
Key words
animal
hoarding
pets
self-neglect
squalor
H
oarding behavior in humans can involve pathologi-
cal self-neglect and is associated with a variety of
psychological conditions, particularly obsessive–
compulsive disorder (OCD) (Damecour &
Charron,1998; Frost, Krause, & Steketee,1996).
Some evidence exists that elderly people may be dispropor-
tionately affected (Steketee, Kim, & Frost, 2001). Animal hoard-
ing is a recently described behavior that shares many features
of OCD hoarding but seldom has been considered a symptom
of psychopathology (Frost, Steketee, & Williams, 2000;
Patronek, 1999; Worth & Beck, 1981). In typical cases, people
are living with dozens to hundreds of alive and dead animals
in apartments, trailers, and single-family homes (Patronek;
Worth & Beck). Lack of insight into the severity of their living
circumstances and denial of the risks or harm to animals is
common.
This public health problem is believed to occur in every
community but is poorly understood (Patronek, 1999). Our
experience and studies of news reports (Hoarding of Animals
Research Consortium [HARC], 2000) suggest that animal
hoarding knows no social or economic boundaries. Although
typically identified among unemployed and socially isolated
individuals, anecdotal reports indicate that animal hoarding
also has been discovered among physicians, veterinarians, bank-
ers, nurses, teachers, and college professors. Employed hoard-
ers appeared to be able to live a double life, with coworkers
never suspecting the true conditions in their homes until ani-
mal rescue authorities were called to investigate. Despite its
seriousness, almost no empirical research exists on this prob-
lem (Frost et al., 2000).
Recently, two studies examined animal hoarding. A review
of 54 cases initiated by animal care agencies primarily to res-
cue the animal victims indicated that public health officials
who were aware of the problem ignored indicators of clini-
cally significant human health concerns (Patronek, 1999). Ig-
noring the health concerns was common, despite ample evi-
dence to suggest substantial impairment in functioning of the
hoarders, and severely cluttered and unsanitary living envi-
ronments that posed a threat to human safety and health. In
11 percent of cases, the residences were condemned as unfit
for human habitation. In 26 percent of cases the hoarder was
126
Health & Social Work / Volume 27, Number 2 / May 2002
eventually institutionalized or placed under some
type of protected care, suggesting very serious
mental and physical impairment (Patronek). A re-
curring comment from investigators was that
some agencies responsible for monitoring human
health concerns had declined to intervene and
were unaware of the implications of the behavior.
Another study examined cases of hoarding of pos-
sessions generated by complaints from neighbors,
police, fire departments, social services agencies,
and service personnel to local health departments
in Massachusetts. In hoarding cases that involved
animals, public health officials reported signifi-
cantly worse sanitary conditions, threats to indi-
viduals’ health, and involvement of a greater num-
ber of agencies in the investigation (Frost et al.,
2000).
These findings support our belief that animal
hoarding is a serious public health problem that
has received virtually no attention from the clini-
cal or research communities. Findings from case
reports (Patronek, 1999) and in-depth interviews
of a small number of animal hoarders have sug-
gested various models of psychopathology (HARC,
2000). The study reported in this article provides
more information about the degree of impairment
of activities of daily living (ADL) associated with
animal hoarding, as well as the frequency and se-
verity of effect that this behavior had on the health
and safety of household members.
Method
Because no single agency is responsible for re-
sponding to reports of animal hoarding, we solic-
ited reports from a broad spectrum of people likely
to encounter cases of animal hoarding (for ex-
ample, animal control officers, humane law en-
forcement or other police officers, public health
veterinarians, elder services case workers, and
health departments). Reports were solicited from
national veterinary meetings, professional con-
tacts, news articles, listservs, and an Internet Web
site. Cases also were identified through electronic
search of the news media using keywords such as
“cats” and “stench.” We obtained a convenience
sample of 71 professionals.
Participants were asked to submit a detailed
standardized case report form created by HARC
(see Appendix A). A case report questionnaire used
in an earlier study (Patronek, 1999) was revised to
obtain more detailed information on household
functioning and risk to occupants. Professionals
who had visited the home and interviewed house-
hold members were asked to rate the degree of
impairment of ADL, such as ability to maintain
personal hygiene, move about, and prepare food
and to assess risk to occupants from clutter and
unsanitary condition. They also were asked to re-
port functionality of utilit ies and major appliances.
Finally, we conducted a follow-up interview with
each professional to obtain a narrative account of
the case, with a focus on the presence of, and risk
to, dependent family members living with animal
hoarders. Although it was not possible to verify
independently all of the information in the case
reports, photos and media or police reports cor-
roborated the data from the questionnaire and
narratives in 29.6 percent (n = 21) of the cases.
Data were entered into a commercially avail-
able software package (SPSS), which also was used
to generate descriptive statistics. When age was
indicated within a range, midpoint values were
used. A composite score for ability to move about
in the home was created by summing the values
for ability to move about the kitchen, dining room,
and living room and to exit the house quickly.
Results
Seventy-one case reports were received from 28
states and one Canadian province. The largest
number of reports came from animal control de-
partments or humane societies (83.1 percent); the
remainder came from police departments (5.6
percent), social services agencies (4.2 percent),
municipal agencies (4.2 percent), a health depart-
ment (1.4 percent), and a veterinarian (1.4 per-
cent). Of the 71 hoarding cases, 83.1 percent were
women and 16.9 percent were men. Median ages
were 55 years for women and 53 years for men.
Ten of 66 hoarders (15.1 percent) for whom age
could be confirmed were 65 years of age or older.
The total number of animals involved per case
ranged from 10 to 918. The mean and median
numbers of animals were 55.8 and 47, respectively,
for men and 90.1 and 50, respectively, for women.
Women (13 of 59; 22.0 percent) were more likely
than men (1 of 12; 8.3 percent) to have more than
100 animals. We found no apparent relationship
between age group and animal population size,
although hoarders in the 50-to-64-year-old group
tended to have a greater number of animals (me-
dian = 55) than people under 50 (median = 44.5)
or people 65 and older (median = 38). Animals
involved in the 71 cases were cats (81.7 percent),
dogs (54.9 percent), birds (16.9 percent), reptiles
(5.6 percent), small mammals (11.3 percent),
127
Health Implications of Animal Hoarding
horses (5.6 percent), and cattle or sheep or goats
(5.6 percent). There was no obvious association
between the type of animal involved and gender
of hoarder, whether the hoarder lived alone, age
of the hoarder, or ability to move around in the
home. The mean [median] number of animals
involved was somewhat greater for employed in-
dividuals (n = 23, M = 94 [56]) than unemployed
individuals (n = 39, M = 87 [42]).
Nearly three-quarters (71.8 percent) of the 71
hoarders were single, widowed, or divorced. In
more than half of the cases (53.5 percent) other
individuals were living in the home, including chil-
dren, bedridden or otherwise dependent elderly
people, and disabled people. Of 62 individuals for
whom employment status was provided, most
(54.9 percent) were described as unemployed, re-
tired, or disabled. Hoarders who were employed
held a variety of jobs, including those considered
white-collar or professional positions, such as
teacher, mortgage broker, realtor, or marketer.
Nearly one-third of the 71 hoarders had been
monitored or investigated for four years or more
(29.5 percent); 46.5 percent were recent investiga-
tions begun within the past year; and 23.9 percent
had been monitored for one to three years. A his-
tory of recidivism was mentioned for 25.3 percent
of hoarders. In all of the households, objects, in
addition to animals, were hoarded—newspapers,
books, containers, clothing, and food or food gar-
bage (Table 1). In one case debris piled four feet
deep made it impossible to stand upright, and the
occupant could only move about by crawling.
Activities considered basic to maintaining a
functional and sanitary household (for example,
using bath or shower, sleeping in a bed, or prepar-
ing food) were rated as very much impaired in from
one-half to three-quarters of cases (Table 2).
Greater impairment in these activities was reported
for single-person compared with multiple-person
households. Median composite scores for ability
to move about the home increased (indicating
greater impairment) with the age of the hoarder
(< 50 years, n = 18, score = 7.0; 50 to 64 years, n =
33, score = 9.0; ≥ 65 years, n = 10, score = 11). The
median score for men was slightly higher (n = 11,
score = 10) than for women (n = 55, score = 9).
(Data were unavailable for four of the women and
one of the men.) Median scores also tended to be
higher for hoarders living alone (n = 32, score =
10.5) than for hoarders living with other people (n
= 34, score = 8.5). (Data unavailable for five of the
hoarders.) Essential utilities and major appliances
were commonly reported to be not working, espe-
cially shower or tub, stove, toilets, and sinks. Greater
dysfunction seemed present in single-person
households (Table 3). Danger from falling as a re-
sult of the clutter was reported in 80.2 percent (n
= 57) of cases and danger from fire hazards in 70.4
percent (n = 50) of cases. In one case in which the
heat was not working, it was noted that the fire-
place adjacent to a cluttered couch was the only
source of heat. The residence was rated very un-
sanitary in 93.0 percent (n = 66) of cases, and at
least 12 residences (16.9 percent) were ultimately
condemned or deemed unfit for human habita-
tion. Hoarders eventually were placed in some type
of permanent or temporary protective care in one-
quarter of cases (n = 18, 25.3 percent).
The hoarders’ justification for accumulating and
living with animals varied (Table 4). Although love
for animals was a ubiquitous theme, the role of
animals as children or surrogate family members
was also common, cited in about 40 percent of
cases. Hoarders accumulated animals using pas-
sive and active methods. Accidental breeding of
the animals was the single most common reason,
ranked first or second in 56 percent of cases (n =
Table 1. Extent of Concurrent Hoarding of Inanimate Objects among Animal Hoarders (
N
= 71)
Food or
Newspapers Books Clothing Containers Garbage
Extent of Hoarding n%n%n%n%n%
Severe 15 21.1 7 9.9 14 19.7 21 29.6 22 31.0
Substantial 16 22.5 12 16.9 13 18.3 12 16.9 23 32.4
Moderate 16 22.5 20 28.2 20 28.2 19 26.8 12 16.9
None 11 15.5 15 21.1 8 11.3 6 8.5 6 8.5
Not rated 13 18.3 17 23.9 16 22.5 13 18.3 8 11.3
128
Health & Social Work / Volume 27, Number 2 / May 2002
Table 3. Essential Utilities and Appliances Reported Not Functioning in Cases of Animal Hoarding, by
Companionship Status
(N
= 71)
Live Alone Live with Others
Utility or Appliance n/n rated % n/n rated %
Electricity 5/29 17.2 5/36 13.9
Heat 8/20 40.0 5/26 19.2
Hot water 8/11 72.7 5/17 29.4
Bathroom sink 9/17 52.9 8/27 29.6
Kitchen sink 12/23 52.2 9/29 31.0
Laundry facilities 11/12 91.7 9/11 81.8
Shower or bathtub 11/14 78.6 17/26 65.4
Stove 12/17 70.6 9/22 40.9
Refrigerator 8/22 36.4 7/28 25.0
Toilet 9/16 56.3 9/30 30.0
40). However, active solicitation from the public
was ranked first or second in 46 percent of cases (n
= 33).
Descriptive statistics do not begin to capture
the extreme nature of many of these situations. In
a typical case, household interiors were coated,
often several inches high, with human and animal
urine and feces, sometimes to an extent that floors
buckled. When animal control or humane society
agents entered these homes to remove the animals,
the contamination and toxic atmosphere some-
times made it necessary to wear protective cloth-
ing and a breathing apparatus. In many cases, sani-
tary food preparation and storage were impossible
or nonexistent.
As noted earlier, although hoarders tended to
be single, it was not uncommon for dependent eld-
erly or disabled family members to be present. This
was true in at least 21 percent of cases (n = 15). In
one case, a 33-year-old woman lived with her 79-
year-old parents in a home with more than 200
cats. In another case, a 58-year-old man lived with
his 91-year-old bedridden mother, three other rela-
tives, and 26 cats in a single-family home. Bags of
debris were piled five feet high, leaving only nar-
row tunnels through the home. In yet another case,
a 53-year-old woman lived with her 80-year-old
mother and 24 cats without litter boxes in a home
without running water. The mother used a bucket
as her toilet. One woman in her sixties lived in a
Table 2. Activities of Daily Living Reported as Very Much Impaired among Animal Hoarders, by
Companionship Status (
N
= 71)
Live alone Live with others
Activity Impaired n/n rated % n/n rated %
Use of bath or shower 16/26 61.5 19/32 59.4
Using bathroom sink 14/28 50.0 13/31 41.9
Sleeping in bed 14/25 56.0 16/31 51.6
Finding important objects 20/28 71.4 19/32 59.4
Maintaining basic personal hygiene 23/31 74.2 27/35 77.1
Using kitchen sink 22/28 78.6 18/33 54.5
Preparing food 26/30 86.7 23/33 69.7
Using kitchen table 19/25 76.0 15/29 51.7
Using dining room table 17/19 89.5 15/26 57.7
Using toilet 14/26 53.8 17/32 53.1
Sitting in living room 20/28 71.4 17/33 51.5
Exiting home quickly in case of danger 19/31 61.3 15/35 42.9
129
Health Implications of Animal Hoarding
trailer with her mentally retarded adult daughter,
13 dogs, and 13 cats. Clutter limited access to most
of the home, including the bathroom.
Dependent children were present in 5.6 percent
(n = 4) of the cases. One woman in her twenties
lived with her blind female partner and eight-year-
old child, along with 28 cats and two rabbits. The
floors were covered in feces, and the refrigerator
contained moldy and rotten food. In another case,
two teenage girls lived with their mother in a trailer
covered with feces. Dogs, cats, calves with diarrhea,
and numerous other farm animals also lived in-
side. One 40-year-old couple was eventually
charged with child endangerment, but only after
their two children needed to repeat kindergarten
and first grade because of chronic absences asso-
ciated with respiratory infections. They lived with
58 cats, 12 birds, and 11 other animals. Odor had
been reported to school authorities. One hoard-
ing situation involving dogs resulted in flea infes-
tation of a nearby school for emotionally disturbed
children, causing the school to shut down.
Several individuals were clearly at special risk
of infectious diseases because of immunosuppres-
sion or other medical condition. One 48-year-old
woman, a recipient of a bone marrow transplant,
lived in a mobile home with 80 animals, including
30 birds and 10 reptiles. This situation appeared
to be particularly dangerous, because salmonella
shedding is known to be ubiquitous in captive rep-
tiles. Another hoarder was reported to be an insu-
lin-dependent diabetic; insulin injections were
presumably administered in the unsanitary home.
To prevent her from wandering, a husband had
locked his 80-year-old wife with dementia inside a
trailer with 40 cats. After rescue, her head needed
to be shaved, because of the filth and matting of
her hair.
A recurrent theme in the narrative reports was
the difficulty in getting human health agencies to
take these cases seriously. One environmental
health officer was reported to have commented that
“The only exterior problem was odor, which is not
a health hazard to the community. Her home is
her domain and she can live as she wishes”. In one
community it was only after media attention high-
lighted the failure of public agencies to act that the
regional Society for the Prevention of Cruelty to
Animals was invited to join the county multidisci-
plinary elder abuse consultation team.
Limitations of the Study
No single agency is responsible for investigating
or resolving hoarding cases, and no mandate or
standard procedure exists for reporting hoarding
cases. This is true for hoarding of animals or pos-
sessions. Therefore, there was no existing sampling
frame to use, and it was not possible to estimate
case retrieval or response rates from the agencies
that participated. Because the data were reported
retrospectively, not all information requested
could be provided, and we were only able to verify
reports in about one-third of the cases. Thus, this
case series represents unvalidated data from a con-
venience sample, and therefore generalizations
from these data would be premature. Similarly, dif-
ferences suggested by subgroup analyses (for ex-
ample, gender) should be regarded as preliminary,
given the sample size and lack of statistical signifi-
cance testing. It is important to note that animal
hoarding exists on a continuum from mild to se-
vere. Thus, the cases reported to public health of-
ficials described here undoubtedly are skewed to-
ward the more severe end of a wider spectrum.
Nevertheless, several years of careful scrutiny of
hundreds of media reports (Arluke et al., in press)
and personal communication with people involved
in resolving these cases make it clear that the cases
reported here are by no means unique or even the
most extreme examples.
Discussion
Several features stand out in this case series. In the
majority, if not all, of the cases there was compel-
ling evidence of self-neglect by the animal hoarder,
and when dependent family members were
present, neglect of them as well. Not uncommon,
this rose to the level of abuse and sometimes per-
sisted despite awareness of staff at public agencies
that grounds for concern existed. In some cases,
human health agencies discontinued involvement
after criteria to establish mental incompetence
were not met, despite clear risks from self-neglect,
Table 4. Reasons Given by Animal Hoarders for
Accumulating Animals (
N
= 71)
Reason n%
To save the animals 48 67.6
Loves the animals 57 80.3
No one else would care for them 37 52.1
Surrogate children 26 36.6
Animals were their only friends 28 39.4
130
Health & Social Work / Volume 27, Number 2 / May 2002
falls and injury, poor nutrition, and extreme lack
of sanitation. Particularly in the case of frail or
immunocompromised individuals, the potential
for infection and zoonotic disease seemed substan-
tial. When stoves or fireplaces were used as the
source of heat in homes without functioning utili-
ties, the clutter posed a fire hazard. Despite these
seemingly obvious human health and safety issues,
intervention was typically secondary to attempts
by animal control or protection groups to help the
animal victims involved.
The extreme nature of the living environments,
a trend toward greater dysfunction in single-per-
son households, and the presence of dependent
family members in multiperson households sug-
gest that all cases of animal hoarding pose poten-
tially serious risks to human health and welfare.
Why extreme lack of sanitation and toxic atmo-
sphere was tolerated by the hoarders and their live-
in family members remains to be determined. As
with other forms of elder abuse, in some cases it
appeared that the extreme conditions were toler-
ated by elderly family members in return for hu-
man care and companionship. In cases where self-
neglect was the primary feature, it is likely that the
perceived benefits of animal companions out-
weighed the discomfort from the environment. It
also remains to be determined to what extent so-
cial isolation was a cause, rather than an effect, of
animal hoarding, and to what extent broadening
the social network of hoarders might reduce the
need for animals. In this case series, there was ample
evidence that some people in the hoarder’s social
network encouraged acquisition of animals, either
by bringing them to the hoarder or encouraging
others to do so, under the pretext of providing care
for a needy animal or avoiding the possibility of
euthanasia in a shelter. The challenge of any inter-
vention will be to decrease isolation and discour-
age enablers.
Other features of these situations, as well as
structural aspects of the system, add complexity
and challenge to resolving these cases. And right-
fully so; existing laws tend to prevent elderly people
from being easily ousted from their homes. How-
ever, self-neglect is the most common form of el-
der abuse and neglect reported to state agencies
(O’Brien et al., 1999), and the signals for self-ne-
glect include many of the features common to
animal hoarding, such as poor nutrition, lack of
medical care, poor personal care, little or no aware-
ness of the consequences of choices, social isola-
tion, and extreme clutter that interferes with
ambulation. The presence of these criteria alone
are often insufficient to establish mental incom-
petence, despite the fact that the typical self-ne-
glector frequently has significant comorbid con-
ditions (O’Brien et al., 1999). It is important for
human health and social services professionals to
appreciate that when dozens to hundreds of ani-
mals are involved, all of the other problems asso-
ciated with the hoarding of inanimate possessions
are exacerbated by the potential for extreme envi-
ronmental contamination from urine and feces.
This may exponentially increase the level of risk
and exposure to zoonotic disease. For example,
ammonia is a potent ocular and respiratory irri-
tant at concentrations of 50 ppm or greater (Na-
tional Institute for Occupational Safety and Health,
1994). OSHA recommends that eight-hour occu-
pational exposures not exceed 35 ppm and the
National Institute for Occupational Safety and
Health lists concentrations of 300 ppm or greater
as immediately dangerous to life and health (Oc-
cupational Safety and Health Administration,
1989). Little information exists about ammonia
levels in animal hoarding situations, but in one
case, air ammonia levels were recorded as 152 ppm
after the home had been ventilated by the fire de-
partment (personal communication with Dr L.
Lembke, instructor, Stautzenberger College, To -
ledo, Ohio, February 23, 2001). Because it is well
established that investigators or caseworkers often
require respiratory protection from the caustic
atmosphere when entering a hoarder’s home, there
is good reason to believe that environmental am-
monia levels frequently approach harmful levels.
It remains to be determined whether hoarders
themselves have become anosmic (unable to de-
tect odors as a result of a temporary or permanent
impairment of their sense of smell) or simply ac-
climated to the conditions. If it is the former, then
the ability to tolerate a toxic atmosphere may be
evidence of neurological damage.
We suspect that human social services and men-
tal health agencies are often unaware that animal
protection laws in every state specify that compan-
ion animals must be kept in sanitary environments
and receive proper nutrition, potable water, and
necessary veterinary care to relieve suffering. The
typical animal hoarder situation is likely to violate
these laws. If the hoarder fails to cooperate with
social services agencies, animal protection statutes
provide an alternate avenue for intervention. In
some cases, a worthwhile strategy may be to nego-
tiate a situation in which the hoarder is allowed to
131
Health Implications of Animal Hoarding
keep a small number of special pets if she or he
brings living conditions up to par and consents to
regular monitoring. Animal control or sheltering
groups and veterinarians are logical allies in such
a plan. A desirable side effect would be an improve-
ment in the living situation for the hoarder and
household members. Given the high potential for
recidivism in cases in which all of the animals are
abruptly removed, this strategy may represent the
best possible option for circumventing the denial
and reluctance to cooperate that characterize ani-
mal hoarders and may provide some hope for long-
term control of the situation.
Animal hoarding behavior transcends multiple
pet ownership. The problem merits greater atten-
tion and requires considerable study to character-
ize precisely its nature and cause. Animal hoard-
ing is not yet listed as indicative of any specific
psychological disorder and is not recognized as a
clinical entity. Therefore, it is premature to attach
any diagnostic labels to this behavior. Nonethe-
less, the bizarre living conditions and serious im-
pairment noted in this case series suggest that in
some cases, animal hoarding may indicate the
need for psychological assessment. Deliberate ani-
mal abuse and neglect already have been identi-
fied as a valuable indicator of various forms of
family violence or dysfunction (Ascione & Arkow,
1999). Therefore, it seems logical that recognition
of the potential for animal hoarding to act as a
sentinel for hoarders and dependent household
members at risk could facilitate identification of
other unmet human health and medical needs. In-
creased collaboration among animal control and
protection groups, veterinarians, and social ser-
vices agencies to identify hoarding situations
could provide opportunities for earlier interven-
tion and forestall more serious outcomes for the
hoarder, household members, and communities.
Establishing a community task force, as some
communities have done to respond to the extreme
hoarding of inanimate possessions, may be espe-
cially helpful in devising appropriate intervention
strategies for animal hoarding. Such a task force
would include officials and service providers rep-
resenting departments of health, fire, police, hous-
ing, mental health, aging (when elderly individu-
als are involved), and adult protective services, in
addition to animal control officers, representatives
of shelters and humane societies, and veterinar-
ians. A task force can develop decision trees to
address identified problems and coordinate inter-
ventions. Increased cross-disciplinary training
about the role of animals in peoples’ lives and di-
rect communication among multiple service agen-
cies about hoarding could reduce frustration and
costs and improve cooperation and outcomes for
hoarders and their families.
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About the Authors
Arnie Arluke, PhD, is professor,
Department of Sociology and
Anthropology, Northeastern University,
Boston. Randy Frost, PhD, is professor,
132
Health & Social Work / Volume 27, Number 2 / May 2002
Department of Psychology, Smith College,
Northampton, MA. Carter Luke, BA, is
vice president, Animal Protection
Division, Massachusetts Society for the
Prevention of Cruelty to Animals, Boston.
Edward Messner, MD, is a psychiatrist,
Department of Psychiatry, Massachusetts
General Hospital, and associate clinical
professor of psychiatry, Harvard Medical
School, Boston. Jane Nathanson, LCSW,
LRC, CRC, is a social work and
rehabilitation consultant, Massachusetts
Society for the Prevention of Cruelty to
Animals, Boston. Gary J. Patronek,
VMD, PhD, is director, Center for
Animals and Public Policy, and assistant
professor, Department of Environmental
and Population Health, School of
Appendix A. Case Report Form
For purposes of this project, only submit cases consistent with the following definition of an animal
hoarder:
Someone who has accumulated a large number of animals and who fails to provide minimal standards of
nutrition, sanitation, and veterinary care; and fails to act on the deteriorating condition of the animals
(including disease, starvation, or death) and the environment (severe overcrowding, extremely unsanitary
conditions) or the negative effect of the collection on their own health and well-being and on that of other
family members.
1. What was the origin of the complaint? Circle all that apply:
1. Stranger 2. Friend or acquaintance 3. Relative not living there
4. Family member or roommate 5. Social services agency 6. Service person visiting home
7. Landlord / tenant / neighbor 8. Fire or Police Dept. 9. Veterinarian
10. Anonymous 11. Other:
2. Please list the people living in the house, their age, sex and relationship to the person in question:
Person Age (yrs) Sex Relationship to hoarder (circle correct choice)
1. Hoarder M F n/a
2. Person 2 M F parent, child, sibling, grandparent, other relative, partner, roommate
3. Person 3 M F parent, child, sibling, grandparent, other relative, partner, roommate
4. Person 4 M F parent, child, sibling, grandparent, other relative, partner, roommate
5. Person 5 M F parent, child, sibling, grandparent, other relative, partner, roommate
3. Please circle the marital status of the hoarder:
Single Married Divorced Widowed Partner/Significant Other Unknown
Veterinary Medicine, Tufts University,
North Grafton, MA. Michelle Papazian,
MSW, LICSW, is social work coordinator,
Children’s Hospital AIDS Program,
Boston. Gail Steketee, PhD, is professor,
School of Social Work, Boston University.
Funding for this study was provided by
the Edith Goode Trust and the Kenneth
A. Scott Trust. For correspondence and
reprint requests contact Gary J. Patronek,
VMD, PhD, Department of
Environmental and Population Health,
School of Veterinary Medicine, Tufts
University, 200 Westboro Road, North
Grafton, MA 01536; e-mail: gary
patronek@tufts.edu.
Accepted January 9, 2002
4. Please circle the type of residence:
Single family home Apartment/ Condo Trailer Other (describe):
5. Please indicate the occupation of the hoarder: ____________________________________________________
6. Please indicate what other agencies are involved in the case:
Mental Health Yes No Unknown
Fire Department Yes No Unknown
Police Department Yes No Unknown
Department of Aging Yes No Unknown
Child Welfare Yes No Unknown
Court Yes No Unknown
7. Please indicate what areas of the house were cluttered and the degree of clutter present:
Cluttered Areas Extent of Clutter (circle best choice)
Bedroom None Moderate Substantial Severe Unknown
Bathroom None Moderate Substantial Severe Unknown
Living room None Moderate Substantial Severe Unknown
Kitchen None Moderate Substantial Severe Unknown
Dining room None Moderate Substantial Severe Unknown
Stairwell None Moderate Substantial Severe Unknown
Hallway None Moderate Substantial Severe Unknown
Basement None Moderate Substantial Severe Unknown
Attic None Moderate Substantial Severe Unknown
Outside None Moderate Substantial Severe Unknown
8. Please indicate whether the following appliances /utilities were in working order:
Stove/Oven Yes No Unknown Fridge/Freezer Yes No Unknown
Kitchen sink Yes No Unknown Bathroom sink Yes No Unknown
Washer/Dryer Yes No Unknown Toilet Yes No Unknown
Electricity Yes No Unknown Water heater Yes No Unknown
Furnace/Heat Yes No Unknown Shower/Tub Yes No Unknown
9. Please indicate the extent to which each of these activities is impaired or affected by the hoarding:
Due to clutter, does this Not Not Very
person have difficulty: Applicable at all Somewhat Much
a. preparing food? N/A 1 2 3
b. using the kitchen table? N/A 1 2 3
c. using chairs in the kitchen? N/A 1 2 3
d. using the sink in the kitchen? N/A 1 2 3
e. moving around in the kitchen? N/A 1 2 3
f. using the toilet? N/A 1 2 3
g. using the bath or shower? N/A 1 2 3
h. using the bathroom sink? N/A 1 2 3
i. sitting in the living room? N/A 1 2 3
j. moving around in the living room? N/A 1 2 3
k. using the dining room table? N/A 1 2 3
l. moving around in the dining room? N/A 1 2 3
m. exiting the house quickly? N/A 1 2 3
n. sleeping in the bed? N/A 1 2 3
o. moving around in the bedroom? N/A 1 2 3
p. going up and down the stairs? N/A 1 2 3
q. finding important papers / objects when needed? N/A 1 2 3
r. maintaining basic hygiene? N/A 1 2 3
Are there places in the home that are fire hazards due
to clutter near furnaces or heaters? N/A 1 2 3
Is the person in danger of falling and getting hurt due
to the clutter present? N/A 1 2 3
Reasonably Somewhat Very
How unsanitary is the residence? N/A Sanitary Unsanitary Unsanitary
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10. Was there any danger in addition to that noted above for the hoarder or other family members from the
clutter or hoarding? If so, please describe:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
11. Please indicate the extent to which each of the following types of items were hoarded:
Hoarded Objects Extent of Hoarding (circle best answer)
Newspapers or magazines None Moderate Substantial Severe Unknown
Books None Moderate Substantial Severe Unknown
Other paper None Moderate Substantial Severe Unknown
Clothing None Moderate Substantial Severe Unknown
Containers (plastic, paper,
bottles, glasses) None Moderate Substantial Severe Unknown
Food or food garbage None Moderate Substantial Severe Unknown
Animals None Moderate Substantial Severe Unknown
Clutter outdoors None Moderate Substantial Severe Unknown
Other (describe): None Moderate Substantial Severe Unknown
12. List number, type, and vital status of all animals in the collection. (Note: If estimated rather than an actual
count of the animals, please note using “~” symbol.)
Number
Number alive but
Number alive but in severely injured,
in good or poor condition; diseased or
adequate not in immediate extremely Number
Type of animal health risk of death malnourished dead Total
Dogs
Puppies (< 1 year old)
Cats
Kittens ( < 1 year old)
Birds
Reptiles
Small mammals
Horses
Cattle / sheep / goats
Other: _____________
13. How long has this individual been monitored or investigated for animal hoarding related problems?
< 1 year 1 – 3 years 4 – 5 years > 5 years
14.Please describe how the majority of animals were acquired. Rate the most common method as 1, the next
as 2, etc. Use each ranking only once.
Animals bred deliberately in hoarders home
Animals bred accidentally in hoarders home
People brought animals to the hoarder
Hoarder purchased or adopted new animals
Hoarder actively solicited new animals by advertisement, picking up strays
Other (describe) _____________________
15. What were the reason(s) stated by the hoarder for having the animals? Check all that apply:
Saving them
Love animals
Animals are like children
No one else would care for them
Animals are their only friends or companions
Other (describe):
16. Circle how many of the individual animals the hoarder was able to identify by name:
ALL MOST SOME FEW NONE UNKNOWN
~
17. Did the hoarder attempt to conceal the presence of the animals in any of the following ways?
YES NO Unknown Covered windows (shades drawn, blackened, etc)
YES NO Unknown Solid fences or other similar external barriers
YES NO Unknown Overgrown vegetation – bushes, trees, hedges, etc.
YES NO Unknown External debris sufficient to block view or access
YES NO Unknown Deny investigator or other persons access to residence
18. What was the resolution of the case investigation? Circle all that apply:
1) All animals were removed from hoarder
2) Some animals were removed from the hoarder
3) Hoarder prohibited from owning animals for a period
4) Hoarder agreed to ongoing monitoring
5) Hoarder ordered to undergo psychiatric evaluation
6) Hoarder was institutionalized or placed under protective care
7) Hoarder penalized by fine or jail term— describe:_______________________
Please briefly summarize the status of the case and the animals. Please describe any unusual features of the
case, including interaction with the mental health system. Continue on reverse if needed.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
19. Please indicate if there was media coverage:
Newspaper Yes No Unknown
Radio Yes No Unknown
Television Yes No Unknown
Name and title of person completing case report form: _______________________________________________
Agency: _______________________________________________________________________________________
Street: _________________________________________________________________________________________
City/ State / ZIP ___________________________________________ Phone ______________________________
20. Did you personally investigate and view this case? YES NO
