When there is a hoarder in the family, the situation is quite different from just having an untidy spouse, messy children, or disorganized parents.

A hoarder fills ALL the available space, ceiling to floor, wall to wall, with stuff. Books, knickknacks, discarded clothing, shoes with holes in them, bits of electronics, 20-year-old software on media for which the computer no longer has a compatible drive, and on and on.

As the resident(s) can no longer access the floors nor get to the walls nor even see the surfaces of furniture, naturally they don't get cleaned. Stuff would have to be removed, thrown out, given away, just to create paths to get from one side to the other.

Often the pathways that exist are just wide enough for the inhabitant(s) to wedge themselves through sideways.

A haven for cats, rats, mice, cockroaches, the premises begin to stink. Dirty clothes, buried and inaccessible under layers of other stuff, add to the miasma. If the hoarder is elderly or ill and can't reach the bathroom in time, other spots in the house may be used instead.

The hoarder becomes deeply upset and angry if anyone tries to clean or sort and toss, holding on to every piece of string and each outdated disc as if it were an integral part of his/her identity. Which it is, hence the adamant refusal to eliminate, the inability to triage what should be kept, given away, or thrown away.

Relatives know this, and know the hoarder's identification with his stuff is what makes cleanup impossible. Would you willingly destroy someone's core identity?

The relative is left with a bewildering relationship in which the hoarder clearly values their inanimate objects more than the living, breathing ones who have to navigate the goat paths through the junk and have to endure the filth. Families of a hoarder develop an ambivalent love/disgust relationship.

Living with a hoarder is being overwhelmed by the environment and being uncomfortable at home, which is the one place where one should be able to relax, to sit. But, no, every chair, every couch, every bed, every table is piled high with stuff, stuff, stuff. And dirty.

One develops "doorbell dread," where it's necessary to live isolated, where it's too embarrassing to entertain guests, even too horrible when someone comes to the door to deliver a package--they might be able to peek inside and see the clutter jungle, smell the stink that wafts out.

Most family members leave as soon as they can, or claim one room of their own (if possible), or come home as seldom as possible, preferring to spend time in the neighborhood bar or the local library or coffee shop. Disappearing into a book or a bottle works sometimes, too.

Or they get through it by thinking, "Some day...."