I recently went to visit a prospective client and found her home to be so cluttered that there was no place to sit. She told me she was “collecting” things because she didn’t want to waste them and she might need them in the future.
There is a big difference between hoarding and collecting. Collectors are usually willing to part with items under the right circumstances. Hoarders are constantly gathering new or additional items and rarely throw or give them away.
Collecting and keeping things make hoarders feel safe.
Older people hoard for a number of reasons:
Reaction to grief or some other trauma – there is a need to fill up the space left by a loss
They do not want to waste
Social isolation – hoarders usually live alone without formal support system
Hoarding provides a feeling of control
Memory loss, paranoia, delusions and other cognitive issues that make it difficult to organize and distinguish between items they need and those they don’t.
Hoarding can be triggered by inherited as well as learned behavior; retirement, poor health; brain injury and illness; depression or dementia.
Some typical behaviors of hoarders include compulsive shopping (especially on television shopping channels), rescuing things other people have thrown out, rescuing animals that they cannot care for, hoarding food, and buying gifts for people they have not yet met. While hoarding can occur in all ages, races, professions and socio-economic backgrounds, it is found disproportionately in seniors and is very difficult to treat. The goal is to reduce the risk of harm and keep them safe.
When should you be concerned:
When the home is not safe and poses a danger to health and comfort.
There are tripping hazards, blocked entry and exit, and/or fire hazards exist.
There is blocked access to the bathroom, trash pileup, signs of insects or rodents, food not stored properly.
There is poor heating or cooling, clutter prevents there being a place to sleep or eat or limits the ability to function properly.
The living situation causes problems with family and neighbors.
When these situations occur, the health department or other state agency (adult protective services, fire department, pest control) may take action.
How to intervene:
Establish a positive relationship with the person and gain their trust and cooperation
Empathize with their point of view
Help them maintain a sense of control by giving them choices
Set goals and time frames for getting things cleaned up
Be respectful of their attachment to possessions
Focus on safety, including fire and fall prevention
Remove belongings when the owner is not present
Do not force a clean up
Do not overwhelm or threaten
Do not expect the situation to change quickly
If the clutter is the result of physical or mental frailty, consider relocating the person to a safer environment.