Many hoarders have obsessive-compulsive disorder, a condition that begins during the teenage years and worsens with age. "These are people who are more attached to things than their friends are. They have a difficult time parting with anything," Steketee says. By the time they reach 30, clutter has started to accumulate; by their senior years, it is a major problem.

It is increasingly viewed and studied as a mental health problem, a complex syndrome that is difficult to cure.

Most of these people "don't think they have a psychiatric problem," says Karron Maidment, program coordinator for UCLA's obsessive-compulsive clinic and an expert on hoarding. "They think of themselves as being clever, creative, unique people who think outside the box." Treatment includes anti-anxiety medicines and intensive psychotherapy programs aimed at weaning hoarders from their collections.

Elderly hoarders sometimes fall into different categories than younger ones. Some suffer from dementia; still others have had to downsize and are overwhelmed by the decisions they must make about what to keep for a smaller space.

"It's a late-life issue," says Steketee. "We want to hang on to our memories, and objects come to take on more significance. We start thinking about what has mattered in our lives; things become the physical embodiment of that."

How can children help? Steketee has some suggestions:

• Don't clean out a home without permission. "This is the fastest way to destroy your relationship with your parent."

• Be consistent, but don't move too fast. "A daughter might slowly help her mother empty one box while asking her about each thing before throwing it away."

• Offer motivation. "Engage them in conversation in a meaningful way. Ask what they'd like to accomplish in their lives in the future. If that includes something like, 'Spend more time with my grandchildren,' the logical reply is 'We'll have to clean out a space for them to sit or a room to play in.' "

• Above all, don't push. "The more you push someone to throw things away, the more they dig in their heels. It never works," Steketee says.

Look in our archives for more on caring for and staying connected with aging parents.

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