Extreme Collecting: Seniors and Hoarding
Charlotte is worried about Mom's safety at home. Mom has always been a bit of a "pack rat." But during Charlotte's last visit to Mom's town, Charlotte realized that Mom had not thrown out a newspaper in five years! Out-of-date food filled the refrigerator, and boxes of odds and ends were piled precariously on countertops so Mom couldn't even use the stove. Charlotte reports, "I offered to help Mom clean up and get rid of some of the junk, but she became very upset. I know I should step in and help, but if Mom won't cooperate, what can I do?"
Collecting things is a human trait, and there is an old saying that one man's trash is another man's treasure. But accumulating items can sometimes grow out of hand. "Hoarding" is the excessive collecting of possessions, including those with no use or value, in a person's home, office, or even their car.
Americans have become more aware of this psychological disorder recently, due in part to several TV reality series on the subject. But hoarding is not a new phenomenon. In most communities, social service agencies have struggled for years to deal with cluttered homes that pose a danger to both the occupant and the community, due to insects and other pests, unsanitary conditions that promote infection, and an increased risk of fire and falls.
Seniors are at greater risk. The first signs of hoarding usually appear in early adolescence, but the problem often becomes progressively worse with age. It is most common, and most dangerous, for older adults.
When does "saving" become "hoarding"?
Almost all of us have a pile of magazines somewhere that we intend to read someday but probably never will. And we might joke about Aunt Laura's huge collection of Hummel figurines. According to the International Obsessive-Compulsive Disorder (OCD) Foundation, "Simply collecting or owning lots of things does not qualify as hoarding." The association points out, "Collectors typically keep their possessions well-organized, and each item differs from others. An important purpose of collecting is to display these items to others who appreciate them." But hoarding goes beyond collecting. 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; and,
Lack of organization that makes it impossible to reach or locate items the person really needs.
The home may be so full of possessions that the person is unable to reach the bedroom, kitchen or bathroom. The home becomes dangerous and unsanitary, and the person may be unable to bathe, perform other personal care tasks, or prepare nutritious meals. Relationships may suffer when the 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 "friends" that provide comfort and security. Extreme hoarding somtimes even leads to eviction and homelessness.
What causes hoarding?
Mental health professionals tell us 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.
Psychologists don't completely understand the origins of hoarding. Some experts classify it as a form of OCD, while others believe it is a separate condition. Stress, depression and dementia can be involved, and hoarding also seems to run in families, both through heredity and environment.
Who can help?
People who are experiencing 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 see the squalor they live in as a problem. Help might come from:
Family and friends. Sometimes 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," you can say, "Let’s stack these shoe boxes up so you can get into the closet." 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 communities now have multi-agency "hoarding task forces," through the local health department, adult protective services agency, or housing department. Check with your city or county government for available resources. 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 other provider. Family members often begin the process, and the specialist who is trained in this problem can help open the conversation with their loved one. Therapists help the person understand the problem and the underlying causes. The goal is for the person to become self-motivated, understanding that the clutter of possessions is a barrier against leading a more satisfying life.
Organization "coaches" and specialized cleaning services. These professionals specialize in home clutter, and will come to the home to help the 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 for compulsive hoarders to 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.