A 58-year-old woman is brought to the PMHNP at the insistence of her adult daughter, who believes her mother has a hoarding problem. The client is adamant she does not have a problem with hoarding. Of the following assessment tools, which one will the PMHNP choose?

Choice A reason: ADL-H evaluates functional impairment related to general daily activities but is not specific for hoarding severity or insight. Choice B reason: HEI provides information on the home environment but is not designed to quantify the severity of hoarding or symptoms. Choice C reason: CIR uses visual images to estimate clutter severity but does not capture behavioral or cognitive aspects of hoarding disorder. Choice D reason: The Hoarding Rating Scale is a validated, standardized tool that assesses the severity, functional impact, and insight of hoarding behavior, making it the most appropriate choice for evaluating suspected hoarding disorder.