Dear Eric >> I have a friend of several decades and recently learned she is a hoarder. We always met outside our homes for coffee or lunch. I just assumed it was more convenient.

A few months ago, she texted to tell me she’s been embarrassed for me to find out her “secret”. She also asked me for help. I was thrilled and offered to help, but she refused to make a commitment.

Later I found out her therapist insisted she reach out to a friend for help. She also confessed she had no intention of letting me near her house. Her mother and daughter are quick to express their disgust at her “problem,” making her shame worse.

I feel nothing but compassion for my friend. I’d leave the problem alone except my friend does a fair amount of animal rescue, particularly cats and kittens. She said one of the rooms in her house is covered with uncleaned feces and mice droppings. I’m worried about her health. Pushing my friend will only make her withdraw. I can’t call authorities as we live in a small town, and she is a well-respected educator. Do you have any suggestions?

— Hoarder’s Friend

Dear Friend >> There are avenues for help but, as with any other compulsive behavior, she has to be willing to take a step toward them. You might give her the book “Buried in Treasure, Help for Compulsive Acquiring, Saving and Hoarding” by David F. Tolin, Randy O. Frost and Gail Steketee, and even ask if she’d be willing to do a “book club” with you about it. Perhaps reading a chapter a month or a week. You might also suggest she give herself the homework of discussing the chapter with her therapist.

Additionally, it may be time to reach out to someone else who has more extensive training. I know you don’t want to expose her to public scrutiny or embarrassment, but the threat to her health and the health of her pets may necessitate bringing in some authorities.

Shame can be managed, the loss of life can’t and many people who hoard live in places that pose extreme risk for fire and can trap themselves or firefighters inside.

Your local or state health department will have resources for people who hoard. Many have so-called “hoarding task forces” with connections to police, fire and mental health support. Often, they’re trained in sensitivity and discretion. I encourage you to reach out.

Send questions to R. Eric Thomas at eric@askingeric.com