Helping a Senior Who Hoards

Related topics: Health & Wellness, Caregiver Skills, Safety

How's your spring cleaning coming? This is the time of year when we air out our houses, dust away the cobwebs, and clean up clutter. As we're throwing out trash and giving away unwanted items, we might make a joke about hoarding. But for some people, many of them seniors, hoarding is no joke.

Senior man in a roomful of clutter

The subject of hoarding seems to fascinate many people. Right along with survival competitions, dating shows and the latest on the Kardashians, reality TV portrays the lives of people who suffer from compulsive hoarding. Experts step in to help the subjects clean up their clutter and change their attitude about their possessions. It's satisfying for viewing audiences to watch a safer, more usable living space emerge from the chaos of junk and filth.

But experts say that these TV programs offer a simplistic picture of the challenges and solutions. In a June 2015 guideline for the treatment of hoarding disorder, the British Psychological Society warned, "The media should seek advice from experts about the portrayal of people with hoarding problems, and desist from using mental health problems to entertain and shock the public."

What is hoarding disorder?

Many people enjoy collecting things. Maybe we bring a fridge magnet home from every vacation. Comic book collectors carefully store each one in a protective bag and try to complete a set. Fashion-conscious women dream of a giant walk-in closet just for shoes. Even if we don't formally collect, most of us have a drawer in the kitchen where, way in the back, we might find that long-forgotten egg slicer and mushroom brush.

But this doesn't qualify as hoarding, according to the International Obsessive-Compulsive Disorder Foundation. They report that signs of hoarding include:

  • Bringing more and more items home, even when there is no space
  • Saving junk mail, package materials and obsolete, useless items
  • Compulsive shopping, sometimes purchasing several of the same item
  • Items unopened in their original packaging
  • Difficulty choosing which items to keep and which to discard
  • Lack of organization that makes it impossible to reach or locate items a person really needs

The house or apartment may be so full of possessions that it becomes dangerous and unsanitary. Occupants are unable to reach the bedroom, kitchen or bathroom, and so are unable to bathe, perform other personal care tasks, or prepare nutritious meals. Relationships suffer when a person is embarrassed to have visitors, or has conflict with friends and family about the condition of their home. This can lead to further social isolation and a cycle where the person perceives possessions as the source of comfort and security. Extreme hoarding may even lead to eviction and homelessness.

Why do people hoard?

Mental health professionals report that patients give these reasons for hoarding:

  • They don't want to be wasteful.
  • They, or someone else, might need the items "someday."
  • Publications and other printed materials contain information they might need.
  • Their possessions have emotional and symbolic value to them.
  • They feel lonely and isolated, and shopping is a social outlet.

The American Psychiatric Association defines compulsive hoarding as a mental disorder, perhaps a form of or related to obsessive-compulsive disorder (OCD). Other experts say hoarding is related to stress, anxiety, depression, loneliness and dementia.

The disorder seems to run in families — though this may be a matter of learned behavior rather than genes. Hoarding also seems to be more common in older adults, but some experts think this is more a matter of increased awareness, when families or community agencies step in to help an elderly person and are suddenly aware of the magnitude of the problem, which actually may have existed for some time.

Who can help?

People who are living with compulsive hoarding usually find it difficult to control the behavior without help. Yet intervention is often difficult and complicated, especially if the person doesn't perceive the squalor they live in as a problem. Help might come from:

Family and friends. Supportive loved ones can be helpful. But often, a family member's tidying up is seen as intrusive interference. In trying to induce their loved one to discard items, family may trigger an even greater emotional attachment to possessions. Social workers suggest that family focus on their loved one's safety. Rather than saying, "Mom, you should throw away all those old shoes," a family member might say, "Let's stack these shoe boxes up so you can get into the closet." And it's important to deal with immediate safety issues first, such as items placed too close to the stove or space heater, or the presence of insects.

Social service agencies. Many cities, counties and states now have multi-agency "hoarding task forces," through the local health department, adult protective services agency, or housing department. In some cases, an agency will step in and order a forcible cleanup, but this is generally not the best solution. The results are often only temporary, and the emotional distress may cause the person to resume collecting with increased vigor.

Mental health professionals. For most people experiencing this problem, progress is difficult without the assistance of a therapist or counselor to help them understand the underlying causes. The goal is for the person who hoards to become self-motivated, understanding that the clutter of possessions is a barrier against leading a more satisfying life.

Aging life care professionals (also known as geriatric care managers). These professionals can help seniors and families develop a plan for dealing with an unsafe living environment and for downsizing when a senior needs to move. They help seniors make decisions about their belongings, and can coordinate services, such as a mental health professional and a cleaning service. Perhaps most importantly, they help seniors and families negotiate the emotional pitfalls as families try to step in to help their loved one clean up.

Organization coaches and specialized cleaning services. These professionals specialize in home clutter, and will come to the home to help a person develop a strategy for sorting, organizing and discarding possessions. Some cleaning services also specialize in hazardous and extremely cluttered home conditions.

Support groups. In-person and online groups, some facilitated by professionals, provide a safe place where compulsive hoarders receive encouragement, advice and understanding as they work to bring organization and control to their own lives. Support groups are also available for family members.

Though it may seem like an uphill battle where removing one item causes two more to appear in its place, the final rewards can be great. People who successfully gain the upper hand over their proliferating possessions are not only much safer in their homes, but also feel a greater sense of control over their lives.

Source: IlluminAge Communication Partners; copyright 2016 IlluminAge