Understanding Hoarding in Seniors


As part of our August topic of the month, Sound Options has been discussing the spaces we live in and how it impacts seniors’ lifestyles, safety, comfort, even how they age. One of the most tragic issues concerning a living space is when a loved one exhibits hoarding behavior that compromises their quality of life. We naturally accumulate things over the years, but you may wonder at what point does collecting things become hoarding? This pattern of accumulation becomes a debilitating situation known as hoarding when the excessive collection and retention interferes with function such as home, health, safety, family, work and social life. The Mayo Clinic defines hoarding as the “excessive collection of items, along with the inability to discard them”.

Hoarding behavior found in the age group of 60+ is known as Diogenes Syndrome.  About 50% of hoarders with Diogenes Syndrome have dementia. According to Dr. Thomas Weiss, a Geriatric Psychiatrist, there are 5 components to the disorder:

  • Extreme Neglect of Self
  • Domestic Squalor
  • Social Withdrawal- Refusal of Help
  • Utter Disregard of Consequences
  • Hoarding Rubbish Excessively 

Understanding the Safety Hazard

While hoarding can cause safety concerns for anyone, seniors are particularly at risk. Understanding the safety hazard can be an important first step in getting help.

  • Increased risk for fall and injury due to blocked pathways and unstable objects
  • Loss of usable space for sanitary food preparation and sleep area.
  • Many aging adults deal with COPD which is inflamed by the low air quality in the home caused by dust accumulation, mold, pet hair, etc.
  • Needed repairs in the house go unnoticed due to the clutter and often cause larger health issues such as mold from flooding.
  • Pets can often be neglected or receive improper care. Some hoarders may hoard multiple pets as well.
  • There is often a risk of fire because of blocked heating ducts and piled flammable materials.
  • For hoarders that have items piled high, there is a large risk injury from falling items.
  • Bills going unpaid due to disorganization can cause important utilities to be shut off.

While it is undetermined what definitively causes hoarding behavior there can be several causes and contributing factors to the behavior such as:

  • Sudden physical disability (such as an injury from a fall, stroke, etc.)
  • Reduced ability to physically care for the home
  • History of mental health issues
  • Symptoms of OCD
  • Dementia

What to Watch For:

  • Failure to discard items/ garbage
  • Individuals obsessively keeping many items that were free or discarded by others
  • Strong emotional attachment to insignificant items
  • Failure to perceive the scope of the problem and the dangers of the behavior- explaining away situations rather than recognizing the pattern.
  • Spoiled food remaining in the fridge and cupboard instead of being thrown out
  • Bills going unpaid due to disorganization
  • Family History:  85% of hoarders have a family history of hoarding

While it may be tempting to come to the rescue, often the process of helping a loved one with hoarding behavior is long. It may seem that the primary problem is an environmental one, but the root of the problem is behavioral, which must be modified over time in order to prevent the same situation from reoccurring. Hoarders often experience embarrassment, shame or guilt with the state of their home and it is common for them to hide the problem. Often by the time individuals are ready to address the problem, it is so overwhelming that they don’t know where to start. If your loved one is exhibiting hoarding behaviors here are a few tips:

Tips for Helping a Family Member

  • Don’t throw away anything without the person’s approval. Always seek buy-in for lasting change.
  • One small space at a time. Turn enormous projects into manageable goals rather than tackle the whole problem at once. One table, one corner, one drawer. This will help your loved one to track their progress along the way. 
  • Sort Items as you go- seeing like items together helps you get rid of groups of items. When you see that you have 9 of the same items, giving away the extras is much easier.
  • Donate items whenever possible- helping others makes it easier to purge items.
  • Allow time for individuals to process and tell stories- Take your time and don’t rush the purging process. Pace yourselves and gradually work over a long period of time. Often purging objects feels like purging memories.
  • Always seek to respect and honor the dignity of an individual who is hoarding. It is always difficult to balance respect for a loved one’s ability to make choices and their need for safety within the home.
  • Defuse tense situations by moving to another area of the house to work on. Don’t get hung up or fixated on one item and let that steal the momentum of the project.
  • Create guidelines to help with behavior modification. Many people tend to think that the clutter in the home is the biggest hurtle to get over, but it is actually the behaviors that created the mess that are most important to address. A clean space will simply be filled again without a change in behavior. Examples of guidelines would be setting a budget for purchased items, a “one item in, one item out” policy, schedules for purging trash/recycling etc.
  • Professional Help. Whether it is a geriatric care manager to guide the process, or a geriatric mental health professional, seeking a neutral third party who is professionally trained to assist in this type of situation takes the pressure off of the family to do it all. Many behaviors have psychological roots and seeking professional help is highly recommended. 
  • Find Resources: Educating yourself on hoarding behavior and how to best help will greatly impact the family dynamics of the experience. Here are a few resources for further information:

Resources/ Books on Hoarding 

 

Published on August 19, 2013.