The gathering impulse has its advantages. Many people happily collect valued possessions, and keep them in good order until needed.

But some people keep so much they have no space to live. They collect piles of paper, old clothes, stray animals and rotten food. They risk injury or fire.

Hoarders keep it all — afraid to discard anything that might someday be useful. Every item seems unique. So to them, each is irreplaceable. They get stirred up if they have to decide what to keep.

Elderly hoarders are often socially isolated and suspicious. They rarely seek help. Hoarding is mainly discovered when a neighbor or police officer notices excess junk, odors or filth.

There is no specific treatment that helps. No medicine has been shown to be effective. A medical evaluation may identify other healthcare needs.

Providing guidance or confronting the behavior is often met with resistance. Cleaning out clutter makes hoarders anxious. They just start accumulating junk again.

Social service agencies cannot intervene unless conditions are clearly dangerous. An agency may be able to visit the home and assess risk. Elder services may help your friend create a space to live and receive visitors.

Support, tolerance and kindness may be your only and best option. Neighborly friendship, in such cases, may be the best medicine.