Understanding Hoarding in Seniors

At Sound Options, we are always discussing the spaces we live in and how it impacts seniors’ lifestyles, safety, comfort, and even how they age. One of the most tragic issues concerning a living space is when a loved one exhibits hoarding behaviors that compromise their quality of life.

It is naturally to accumulate personal items over the years, but at what point does collecting things turn into hoarding? This pattern of accumulation becomes debilitating for the individual when these items interfere with daily life in the home. 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. Those with this disorder have a 46% 5-year death rate because of the unlivable conditions within the home mixed with extreme isolation. 

5 components to the disorder:

  • Seclusion or Extreme Self-Neglect
  • Domestic Squalor
  • Refusal of Help
  • Complete Disregard of Consequences
  • Hoarding Trash 

Understanding the Safety Hazard

While hoarding can cause safety concerns for anyone, seniors are particularly at risk. Understanding the safety hazards 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 sleeping 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
  • 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 or unventilated electronics
  • For hoarders that have items piled high, there is a large risk of injury from falling items
  • Bills going unpaid due to disorganization could 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, unable to care for the home
  • History of mental health issues
  • Symptoms of OCD
  • Dementia

What to Watch For:

  • Failure to discard items or 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 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.

Tips for Helping a Family Member

  • Don’t throw away anything without the person’s approval. Always seek approvals to create a lasting change.
  • One small space at a time. Turn enormous projects into manageable goals rather than trying to 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 - finding matching items helps you get rid of them in groups. When you see that you have 9 of the same items, giving away the extras is much easier.
  • Donate items whenever possible - helping others creates an empowering tone.
  • Allow time for individuals to process and tell stories - Take your time and don’t rush the process. Pace yourselves and gradually work over a long period of time. Often times, giving away objects feels like losing memories.
  • Always seek to respect and honor the dignity of an individual who is hoarding. 
  • 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 hurdle to get over, but it is actually the behaviors that create the mess. 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 donating, recycling or trash, 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 takes the pressure off of the family to do it all. Many behaviors have psychological roots and seeking professional help is very useful. 
  • Find Resources: Educating yourself on hoarding behavior and how to best help will greatly impact the family dynamics during the experience.

Resources / Books on Hoarding 


Published on April 5, 2019.