A Place to Begin Again: Aging & Hoarding While Homeless

When Susan* and her husband divorced, she had no family to turn to once she was expected to move out of her home. She had dedicated herself to a long and successful career in construction and was able to move into a hotel in Salem, where people can rent rooms weekly.

Soon after moving into the hotel, Susan was laid off from her job. Her health declined while she was looking for a new job, which made it difficult to secure income in such a physically demanding field. She used her savings to pay the rent. But when the hotel increased her rent in 2023, she ran out of savings and the hotel evicted her. She was 66.

Health Concerns & Aging While Homeless

For the next two years, she slept on the street, stayed at Lifebridge’s Salem Campus, and spent a short time at the Deborah Walsh Recuperative Center in Lynn for health reasons.

People experiencing homelessness often develop health issues faster than housed people due to constant exposure to harsh weather, poor nutrition, a lack of quality rest, and difficulty accessing healthcare. Daily survival can lead to even more wear and tear on the body, as people experiencing homelessness often carry all of their belongings and walk long distances. As an aging person experiencing homelessness, Susan’s health issues grew exponentially.

Hoarding Disorders & Chronic Homelessness

After recovering at the recuperative center, Susan came to River House, the North Shore’s only women’s shelter. She had developed a hoarding disorder after years of domestic violence in her marriage and losing her home again and again.

“Hoarding disorder is complex. It can be a coping mechanism for fear or in response to a traumatic experience,” says Chelsey Buckley, Lifebridge Programs Director. “If someone is afraid that they’re going to lose everything again, they may hold onto everything they get and develop an emotional attachment to each belonging.”

“Noticing a tendency to hoard is the first step,” says Chandra Slattery, a River House case manager. “For instance, even if a client doesn’t own many clothes, they own a lot of another item that is less essential. It can be anything: hats, books, even antiques. When we notice this trend, we start taking steps to address a possible hoarding disorder.”

When she arrived at River House, Susan was hypervigilant about documentation. She held onto every document she had because she was afraid they’d be taken away. Habits like these can make it more difficult for clients to achieve housing. Many supportive housing programs require regular unit inspections, and hoarding that may lead to health concerns (mold, infestations, etc.) or safety concerns (blocked fire exits, structural damage, etc.) can lead to eviction.

Additionally, document hoarding can make it more difficult for people to stay organized, which can cause a person to struggle with making appointments and maintaining paperwork that keeps them healthy and housed.

Building a Community of Support & Health Services

In order to prevent the chronic homelessness, Lifebridge case managers work with clients on hoarding disorders during their journeys toward permanent housing. Susan resisted taking steps toward housing at first, but Slattery built a trusting relationship and worked with her on her hoarding disorder.

“When someone is showing signs of a hoarding disorder, I connect them with one of our clinicians on staff,” Slattery explains. “I set up a meeting so they can make a plan before the client achieves housing.” These action plans set clients up for long-term success.

Case managers like Slattery also take care to communicate the reasons why overcoming a hoarding disorder is so essential. “It’s important for clients to know the consequences before they move forward.” Slattery says.  “I’ve had honest conversations with clients to explain that they will lose their housing if they continue hoarding habits in a new unit. It’s easy to brush off hoarding, but it could lead to them losing their housing after all their hard work.”

Additionally, Slattery connected Susan with mental health services and providers qualified to help her overcome her hoarding disorder. Since hoarding is so closely tied to the trauma people experience while homeless, mental health services can help clients address the root of the problem. These networks can also continue supporting clients with mental health disorders even after they achieve housing, which helps end the cycle of homelessness.

Working Together Toward Permanent Housing

Slattery also worked with Susan to get an ID, gather important documents, and apply for housing. These tasks are a standard part of the free case management services we offer to all our clients, as complex systems are easier to navigate with an experienced case manager.

On-Going Support After Housing

In December 2025, Susan achieved housing with an apartment in Boston. Slattery and Buckley helped her move into her new home, and a Lifebridge case manager continues to touch base with her as she transitions into her new life. This on-going support helps ensure that if any issues arise while she is housed, Lifebridge can work with her to address them before they lead to homelessness. Housed case management is the key to life-long client success.

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*All names have been changed to protect our clients’ identities.