Unless hoarders admit problem, therapy won’t do much good

Kenneth Epstein is receiving psychiatric treatment locally for his hoarding obsession, but his Las Vegas attorney, Kristina Wildeveld, questioned if the right doctors with expertise in hoarding compulsions are involved.

"I think he is motivated; he just needs the proper people to help him," she said, describing him as delightful, likable and intelligent, yet adding, "He's a person who needs treatment."

She is more upbeat about the success of therapy than at least one cousin. The cousin who spoke to me doubted Epstein will ever admit he has a problem.

"In the past he's just left town," he said. "He'll just do the same thing. He'll blame the government and the establishment."

Wildeveld said there was a lost opportunity when local officials took action. If the city had contacted the television show "Hoarders," Wildeveld said, the program would have paid for the cleanup, restoration, medical care and therapy.

Instead, the bills will go to Epstein.

Wildeveld spoke with Dr. Robin Zasio, who appears on the television show. She said removing Epstein's stuff was like robbing him. Because the cleanup already occurred, the show wouldn't be interested in featuring him, she said.

Epstein was arrested Oct. 12 on six misdemeanor charges at the urging of family members concerned he might try to re-enter his Sun City Summerlin home while it was being fumigated with powerful chemicals.

He made his bond and was released Oct. 16 and taken to a local psychiatric facility, where he remains. A Dec. 6 court date is set in Las Vegas Municipal Court for misdemeanor counts of possession of an unregistered pistol, public nuisance, unjustifiable injury to animals, failure to have a cat fanciers license and a fire code violation.

The cleanup of the Sun City Summerlin home began Oct. 5, and 44 truckloads of materials were removed, each truck hauling about a ton each. Epstein, 55, was allowed to keep items that were not contaminated; four storage containers still are sitting on Gold Bank Drive, awaiting decisions about what to do with them.

Wildeveld said Zasio recommended that the family hold on to the four storage containers of materials Epstein wanted to keep because it will be a critical aspect of his therapy. Allowing a hoarder to choose what to dump and what to keep is the major part of therapy for this compulsion.

Family members originally wanted to get rid of the materials in the containers, though they were fumigated with the home.

A cousin from Maryland flew into town Monday and inspected the shipping containers Tuesday, according to city of Las Vegas spokesman David Riggleman. The cousin decided there are items worth saving.

"At this point the plan appears to be that the containers will be taken to the property of a nonprofit," Riggleman wrote in an email.

If everyone agrees, the family will keep certain family heirlooms, antiques or other items, and the rest will be donated to the nonprofit.

"Our hope is that the containers will be gone by next week," Riggleman's email said.

Even Epstein's lawyer said he doesn't understand that his hoarding created a health and safety issue for his neighbors, who complained for years about the clutter piled in his front courtyard and back patio. They also complained about smells coming from the home.

After officials entered Epstein's home, they found 55 cats, including 15 dead ones, and rotting food, as well as cat feces and walls contaminated with cat urine. Of the 40 living cats, 20 were euthanized because of a contagious respiratory infection. Two kittens are in foster care, and the 18 adult cats remain at the Lied Animal Foundation.

Health officials said the interior needs gutting by removing dry wall, ductwork, insulation, electrical outlet boxes, flooring, windows and window frames.

The city hired an industrial hygienist last week for advice before beginning the interior demolition in case more action is necessary to make the house habitable.

Treatment of hoarding is often a challenge that meets with mixed success, according to the Mayo Clinic website, which said: "For one thing, many people who hoard don't recognize the negative impact of hoarding on their lives or don't believe they need treatment. This is especially true if their possessions or animals offer comfort. And people whose animals or possessions are taken away will often quickly collect more to help fulfill emotional needs."

Treatment for hoarding is intense and time-consuming, and the main treatments are psychotherapy and medications.

Family members are working on creating a guardianship and possibly returning Epstein to the East Coast. If he doesn't relocate and moves back to Sun City Summerlin, it's likely he will resume compulsive hoarding.

Epstein was raised in small towns on the border between New York and Pennsylvania, and his family owned a T-shirt company.

"They lived in places with lots of land," Wildeveld said, so that stuff could be collected and stored.

Family members told officials he has been hoarding for about 30 years in a dozen different homes.

Hoarding experts aren't optimistic about achieving success when the hoarder refuses to admit there is a problem.

Randy Frost, co-author of "Stuff: Compulsive Hoarding and the Meaning of Things," described "clutter blindness" where the hoarder doesn't see it. He described the New York case of "Daniel," 50, who sounded similar to Epstein.

In Daniel's case, there was a forced cleaning. "Within a month the apartment was full again," Frost said.

A social worker arranged for a total of eight cleanings over five years "at a total cost of more than $20,000, a high price to pay for one man who could not control his urge to collect junk," Frost wrote.

Frost's book makes it clear that the hoarder needs to want change before therapy can succeed.

In successful cases he experienced, women were motivated by the threat of losing their children or their families if they didn't change their ways.

While I hope Epstein responds to therapy, I'm not as optimistic as Wildeveld. I suspect the out-of-state cousin is right. He'll just move away and start all over again.

The next time, however, it won't be in a retirement community.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. Email her at Jane@reviewjournal.com or call her at (702) 383-0275. She also blogs at lvrj.com/blogs/Morrison