Hoarding Can Be a Serious Issue
http://www.csa.us/email/spirit/ssarticles/0613Lifestyle.html
Seniors are more likely than others to collect and keep possessions, and are at higher risk for hoarding-related safety issues. The reasons for hoarding are many, including fear of loss and anxiety. Click here to view article.
Hoarding has become a serious enough problem that it is the topic of TV shows and news stories. Although prevalent across society, the act of collecting and keeping more possessions than you can use appears to be more common among seniors than other age groups. In a way, it makes sense; by the time you’ve reached your sixth decade, you’ve accumulated a lot of stuff.
Yet hoarding goes beyond not being able to let go of your old 78 or 45 records (even though you don’t have a record player anymore) or your notes from that college history class. People who are serious hoarders have a hard time controlling their behavior and can be a danger to themselves. For example, accumulated trash can impede movement and block doorways, lead to fires and attract insects or vermin. Further, important documents and bills can become lost in the clutter, which can lead to financial problems. On the whole, letting your possessions overtake your dwelling and life can lead to a poorer quality of life.
Warning Signs
Here are some indications of hoarding:
- Accumulated piles of mail and unpaid bills
- Difficulty throwing things away
- Picking up free, unneeded or worthless items
- Extreme levels of disorganization and clutter, which intensifies over time with powerful emotional attachments to stuffDifficulty walking safely through your home
- Frustration trying to organize
- Difficulty managing activities of daily living
- Expired food in the refrigerator
- Jammed closets and drawers
- Compulsive shopping
- Difficulty deciding whether to discard items
- Expired medications in medicine cabinets
- Using the bathtub for storage
- Keeping papers and magazines on and under beds
- Storing magazines and shoes on steps
Reasons for Hoarding
Experts say that seniors are prone to cluttering for various reasons, including anxiety, depression, fear of loss, not knowing how to get rid of possessions or wanting to hold onto memories. For many hoarders, specific items that no longer hold any intrinsic value, such as a beloved prom dress, still carry strong memories. Hoarders may fear that memories or the past will be lost without that tangible evidence. Seniors often fear what will happen if they give up trivial possessions. Some older adults have been known to save three generations of bank statements because they think they might need them someday.
Many hoarders feel like they are “rescuing” unwanted objects and animals, which gives them a sense of importance, purpose and responsibility. They convince themselves that no one else can take care of the animals, for example, as well as they can.
For a senior hoarder who has lost friends and family, possessions can become a companion, and thus, the more the better. Loneliness can lead to depression, which makes it difficult for seniors to get organized, and a hoarder can start believing that the host of a TV shopping show is a friend. Buying a lot of goods may give the hoarder a momentary high of getting a good deal, an action he or she has to repeat to continue that good feeling. At the same time, with cable TV, Internet and other technological avenues, it’s easier than ever to buy things. And many older adults still carry a Depression-era mindset of wanting to save items for a rainy day.
Serious hoarding is linked to obsessive-compulsive disorder (OCD). People with OCD use rituals (such as hand washing for those obsessed with dirt) to control anxiety produced by persistent, upsetting thoughts. OCD is typically an anxiety disorder, but when an elderly person suffers from it, the condition could be related to Alzheimer’s disease or dementia. People who tend to hoard frequently identify their possessions as central to their identities, so losing or having to get rid of a possession may produce extreme anxiety or a sense of loss and grief.
Seniors who have suffered a brain trauma or stroke, who are wheelchair bound or who are experiencing dementia may no longer be able to manage household duties, which could contribute to clutter. Sometimes, forms of dementia and frontal lobe impairment can bring on Diogenes syndrome. This disorder is characterized by extreme self-neglect, domestic squalor, social withdrawal, apathy, compulsive hoarding of rubbish and lack of shame, according to the American Geriatrics Society. The following circumstances can act as a catalyst for the syndrome: living alone for long periods without appropriate social interaction, a lack of cognitive stimulation, a traumatic event, or a genetic predisposition to the condition.
Treatment for Hoarding
While professionals know much about hoarding’s symptoms and potential reasons, research about treatment is in its infancy. Experts say that hoarding is one of the most difficult mental illnesses to treat, particularly because most hoarders deny they need help.
Trained mental health professionals often treat hoarding with medication, psychotherapy or a combination of the two. Experts recommend antidepressants, called selective serotonin reuptake inhibitors, such as Paxil, to treat anxiety disorders in older adults. Medication can help alleviate the symptoms of conditions that may exacerbate hoarding, such as depression. However, medication alone does not appear to help reduce the symptoms of compulsive hoarding.
The correct intervention depends on the type of hoarding behavior. Although research hasn’t yet confirmed it, there appear to be two subtypes of people with hoarding behaviors, according to Science of Caring.
One group has difficulty with executive functioning—that is, decision-making, planning and following through with plans. For these individuals, cognitive behavioral therapy can be helpful (see sidebar). This psychotherapy helps people change the thought patterns that support their fears, as well as the way they react to anxiety-provoking situations.
For the other subtype—those with impulse control problems and addiction-like behavior—what appears to be effective is a group of peers who provide a nonjudgmental and safe environment of support and encouragement.
In addition, the Institute for Challenging Disorganization provides education and resources to professionals and individuals, including access to professional organizers who offer services to help people with hoarding issues get better control of their environment.
Sources:
Caregiverstress.com, “Senior Hoarding Issues”
A Place for Mom, “Elderly Hoarding: Tips on How to Deal With Diogenes Syndrome”
Mayo Clinic, “Treatments and Drugs”
Science of Caring, “Recognizing and Addressing Hoarding as a Significant Senior Health Concern”
How Cognitive Behavior Therapy Works
Cognitive behavior therapy is the most common form of psychotherapy used to treat hoarding. As part of cognitive behavior therapy, you may:
- Explore why you feel compelled to hoard
- Learn to organize and categorize possessions to help you decide which ones to discard
- Improve your decision-making skills
- Declutter your home during in-home visits by a therapist or professional organizer
- Learn and practice relaxation skills
- Attend family or group therapy
- Be encouraged to consider psychiatric hospitalization if your hoarding is severe
- Have periodic visits or ongoing treatment to help you keep up healthy habits
Source: Mayo Clinic
http://www.optimumseniorcare.com/services/alzheimerscare.php