BEVERLY, Mass.  — After a fire in her home led to the death of 86-year-old Renee Mary of Beverly, Massachusetts, emergency response officials are warning of the dangers of hoarding.

When firefighters arrived at Mary’s home in the small city 30 miles north of Boston, the front door was blocked by so much clutter they had to use a chainsaw to get in. They ran into the same situation at a side door, which had to be ripped off the hinges because it was also blocked.

Fires in homes with “excessive clutter” also led to the deaths of three people in Massachusetts last year, the fire marshall said. With this latest tragedy, officials are urging the public to be more aware of the consequences of hoarding, a mental health disorder characterized by the accumulation of a large number of possessions.

“No one thinks a fire will happen to them, but when one does, these conditions put both residents and responding firefighters in harm’s way,” State Fire Marshal Peter Ostroskey said in a press release.

Mary, who lived alone, was found in the front living room and would have had to pass through the fire to get out, officials said. There were no smoke or carbon monoxide detectors, according to officials, but without clear pathways to more than one exit, they said it is “unlikely” she could have escaped even with early warning.

“This tragedy underscores why it is so important to have two ways out of every room and a clear pathway to the exits,” Beverly Fire Chief Paul Cotter said.

The North Shore Elders Services in nearby Danvers, Massachusetts, sponsors a program that offers groups, counseling and case management services to those living as hoarders, according to Executive Director Paul Lanzikos.

Lanzikos said hoarding disorder has been on the rise, partly because of the accessibility of online and network shopping, he said. 

“Fifteen years ago we saw it occasionally,” Lanzikos said. “Now we see it all the time.”

Marnie Matthews, a clinical specialist at North Shore Center for Hoarding & Cluttering, said there are many misconceptions about hoarding, including that it’s a sign of laziness or being dirty.

“But it truly is a mental health disorder,” Matthews said. “It’s hard for people to understand because it’s something we can stop ourselves. We know we can pick stuff up and throw it out, so we assume they can do it.”

The National Fire Protection Association outlined why hoarding is a fire hazard and why it makes it more difficult for firefighters to do their jobs. When a house is filled with excessive clutter, there are more opportunities for an object to catch fire and ignite, which is what happened in Mary’s home, according to Beverly fire officials.

In homes affected by hoarding, clutter prevents occupants from getting out and firefighters from getting in. According to the National Fire Protection Association, clutter also makes it difficult to find someone who might be trapped and can make it more difficult to extinguish the flames.

Matthews said it’s important to take a “harm reduction” approach when trying to help someone. The center offers a “uniform inspection checklist” to ensure a safe house, starting with unobstructed exits and smoke detectors.

“Rather than saying, ‘You’ve got too many books,’ you can say, ‘I noticed it was difficult to open the front door. How can I help make you safe?’,” Matthews said. “That takes away the judgmental aspect and the focus on the stuff.”

Hoarding is not limited to older people. Lanzikos said it is more likely to be discovered among older people because they have more people coming into their houses to provide assistance.

Matthews said one of the biggest obstacles to people seeking help is shame and embarrassment associated with hoarding. North Shore Center for Hoarding & Collecting offers three support groups run by specialists in hoarding disorders to encourage people to seek help.

“We need to make sure people understand that it’s OK to reach out for that help,” she said.

Leighton writes for the Salem, Massachusetts News.

An earlier version of this story reported that three people were killed in a fire in 2016 because of excessive clutter in Beverly, Massachusetts. The deaths occurred throughout the state of Massachusetts, not in the city of Beverly.