HOARDING DOES NOT HAVE TO BE HOPELESS

Hoarding is an increasing problem in today’s society - news and media outlets have brought its reality to the public’s attention. It’s well known that hoarding causes safety hazards like fall risk, blocked emergency access, and unsanitary living conditions. What’s not as well understood is the emotions behind the behavior, and the difference between a pack rat and a hoarder.

Hoarding is often accompanied by some degree of anxiety, which makes it difficult to treat – and tough for families to watch. And because hoarders tend to self-isolate, it makes their emotional well-being even more fragile.

Senior hoarding issues may indicate the presence of Alzheimer’s, dementia, or mental illness, which makes it even more harmful for seniors. They’re more likely to fall in a crowded home and their health will be harmed by unsanitary or hazardous living conditions. Understanding the emotional side of this behavior can help the family work toward effective solutions in a kind and gentle way.

What Is Hoarding?

Hoarding is when someone compulsively buys and saves objects even though they have so many belongings that they’re creating health and safety issues in their home. Commonly hoarded items may be newspapers, magazines, paper and plastic bags, cardboard boxes, photographs, household supplies, food, and clothing. Seniors who are hoarders resist attempts to get rid of anything, have a fear of throwing away items, and often feel their possessions are:

• Useful or needed for the future,
• Unique, irreplaceable, or have great sentimental value and emotional attachment,
• Incredible “deals” they couldn’t pass up, even if they don’t need or really want it.

Comparable to people with depression, those with a hoarding condition may also experience similar symptoms, such as lack of energy, feelings of hopelessness, problems eating and sleeping, negative thoughts, etc. The clutter will continue to grow, diminishing livable conditions, and creating feelings of anxiety, and a decrease in focus and productivity. The stress of an overly cluttered home can be overwhelming and produce feelings of hopelessness and mental/physical exhaustion.

Hoarding results in serious side effects for older adults, including:

• Preventing emergency care services – firefighters or EMTs may not be able to get through the house to reach them;
• Physical danger – increased risk of falls or not being able to move around due to the extreme clutter;
• Refusing homecare or help in the home – they won’t allow anyone into their home due to embarrassment or fear of their stuff being disturbed (which negatively affects their nutrition, hygiene, and medication);
• Producing unsanitary conditions – spoiled food leads to pests and foodborne illness;
• Creating fire hazards – piles of old papers, newspapers, or magazines can easily go up in flames.

What Causes Hoarding?

Triggers include living alone for long periods of time without social interaction, lack of cognitive stimulation, or a traumatic event. Doctors and psychologists think that hoarding could be a sign that someone has dementia, other cognitive disorders, or a mental illness like OCD, depression, or anxiety.

Someone with depression may exhibit hoarding tendencies, and someone with a hoarding condition may become depressed. Clinical depression is a condition that is characterized by feelings of sadness, hopelessness, and worthlessness for extended periods of time. You may also notice a lack of energy and lack of interest in pleasurable activities. With these feelings, an individual may be unmotivated to almost anything whether hanging out with friends and family or getting up in the morning. Someone suffering from depression may be less inclined to maintain a clean environment. With little ambition to pick up after themselves, the untouched mess may gradually build up over time, developing into the equivalent of a hoarding home.

For those that have experienced a traumatic event in life, hoarding could be a coping mechanism to deal with grief or loss. This is important to consider if your older adult has only recently started the hoarding behavior. They could be trying to fill an emotional hole left by the trauma of losing a spouse or another major life change.

 Another possible cause is something called Diogenes syndrome, which can be brought on by dementia or frontal lobe impairment. Someone with this syndrome shows extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of trash, and lack of shame.

Understanding The Psychology Of Hoarding

There is a difference between a pack rat and a hoarder. Many people like to hang onto mementos and multiples of useful items for both nostalgic and practical reasons. But there are key differences between someone who is an obsessive “collector,” a “pack-rat,” and someone who is a bonafide hoarder.

Many people have a few items they feel emotionally attached to, but a hoarder has an excessive attachment to many possessions and will be uncomfortable if somebody touches them or asks to borrow their items.

A hoarder suffers from an inability to discard items and often acquires useless items. They keep stacks of unnecessary items, like junk mail and old newspapers. They might move things from pile to pile, but will never throw anything away.

A lack of functional living space is common among hoarders, who may also live in unhealthy or dangerous conditions. Hoarders often live with broken appliances and without heat or other necessary comforts. They cope with malfunctioning systems rather than allow a qualified person into their home to fix a problem.

Hoarding also causes anger, resentment, and depression among family members, and it can affect the social development of children. Unlivable conditions may lead to separation or divorce, eviction, and even loss of child custody. Hoarding may lead to serious financial problems, as well.

Even though hoarding can be a coping mechanism for dealing with anxiety, trauma, or other mental struggles, it doesn’t provide real relief. In addition, hoarding behavior often comes with poor decision making, procrastination, and a lack of organization. These impact all aspects of life and make it more difficult to maintain quality of life. And because hoarding is isolating, seniors who hoard typically have limited social interactions. They may even avoid or push family members and friends away, damaging relationships.

People’s perceptions of hoarders can negatively impact a hoarder as well. It’s easy for others to see hoarders as dirty or lazy, and those judgments can be difficult for them to hear and handle. Using hoarding as a coping mechanism could mean that there‘s something in the person’s life that is just too painful to face. Clutter builds up and provides comfort to the hoarder. Letting go of that comfort can feel excruciating.

In fact, hoarders can develop such strong attachments to their possessions that these items become more valuable to them than the people in their lives. Getting rid of something so valuable would feel similar to the extreme grief of losing a loved one. That’s why if someone forces a hoarder to get rid of these items, their anxiety can intensify to unimaginable levels.

Recognizing the Symptoms and Behavior

Someone who hoards may exhibit the following red flags and behaviors:

• Inability to throw away possessions,
• Anxiety when attempting to discard items,
• Difficulty categorizing or organizing possessions,
• Indecision about what to keep or where to put things,
• Distress, feeling overwhelmed or embarrassed by possessions,
• Suspicion of other people touching items,
• Fear of running out of an item or of needing it in the future,
• Checking the trash for accidentally discarded objects,
• Functional impairments, and obsessive/compulsive behaviors that lead to social isolation, family or marital discord, and financial difficulties.

Solutions And Tips To Help Seniors Who Are Hoarders:

So even though it may seem like the most straightforward solution, do your best not to or jump into a big cleanup or throw items away without permission– it would be too emotionally distressing. And if you do get rid of things without a loved one’s approval, it will likely make them see you as an untrustworthy person. That makes it harder for you to continue helping them.

Better ways to help your loved one:

• Visit the doctor - hoarding is connected to health conditions or mental health issues. Having their doctor do a full evaluation will help figure out if the behavior is caused by dementia or other medical conditions. Hoarding can’t truly be fixed until the root of the problem is found and addressed. For some people, medications that treat anxiety and depression may also be able to help with hoarding disorder.
• Consider therapy - if the issue isn’t related to a medical condition, therapy (sometimes in combination with medication) is a way to help seniors manage their hoarding behavior. If the hoarding is linked to a traumatic event, cognitive behavior therapy (CBT) is often an effective treatment. CBT helps the person cope with the emotions from the trauma and learn to manage their grief in a healthier way.
• Encourage them to declutter with kindness and compassion - forced cleanup cause extreme emotional distress, the person you care for will immediately return to their hoarding ways and fill up the space again.
• Be patient and compassionate - go slowly. Break down the task into clearing small areas or rooms over time rather than trying to tackle everything at once.
• Treat even small steps as a victory – throwing away one or two items could be a major event for your senior. Start by getting rid of a small portion of a larger collection to show your senior that they’re capable of letting go of things.
• Do your best not to judge - remember they greatly value the items you see as junk. A hoarder needs professional help to deal with their serious emotional issues before they can cope with cleaning up.
• Help your older adult see that hoarding is a problem - don't shame the person. Instead, an empathetic and rational discussion (or several discussions) will help them gain the courage to do what’s best for themselves. Start by helping them see that a change needs to be made for their own safety.

Contact Us: Sometimes an impartial third party who's not caught up in the family dynamic of a downsizing dilemma can help get the job done more quickly and efficiently. Visiting Angels caregivers are trained to recognize hoarding behaviors, and understand that every personal object in your loved one’s home has special meaning and becomes part of their persona. It's extremely difficult to get a hoarder to downsize at all when they have obsessive-compulsive disorder, so above all, our Angels are empathetic. If necessary, we have professional resources that can assist with the sorting and downsizing process. Our homecare experts understand that your loved one will need to come to their own decisions about what to keep in order to feel good about purging possessions and downsizing.

Till next time!

Irv Seldin, JD

Owner and CEO, Visiting Angels of the Palm Beaches

***This article not intended as medical advice