{ }
AGING
with an
Attitude
A
t an assessment for
home health care, the
client, Mrs. M, made
a point: “And I don’t want
you taking anything from my
bedroom. If you do, I will fi re
you!” she said.
Behind her, granddaughter
Shelley was making gestures
that she would provide more
information later. Shelley
offered to conduct the tour
of grandmother’s bedroom.
“She was never this bad.
When Grandpa was alive,
she would just buy more cute
dog figurines and add to her
huge collection. But since
then, she does not just hoard
things, she goes through the
neighbor’s trash. She takes
things from the fridge and
hides them in her bedroom.
We don’t understand it. She
and Dad fight about this but
she keeps doing it, promising
to clean up but never doing
it. Dad has had enough and
wants to put her in a home.
He thinks she is just
being lazy.”
According to Frost and
Hartl (1996), “Hoarding
and cluttering behaviors
have been defined as the
acquisition of and inability
to discard items that appear
to others to be useless or of
limited value to the extent
that they cause distress or
impairment to those who are
living in the environment.”
(Eckfield, 2010) You prob-
ably would have reacted the
way I did when the bedroom
door opened and I was faced
with Mrs. M’s “collections.”
The smell immediately made
80
Behind a Hoarder's Secrets
me think of how unsanitary
and unsafe the situation was,
worrying about the client
falling or worse, the house
burning down faster because
of all the flammable materials
laying on top of each other.
Then there’s the possibility
of mold, and/or bacteria,
the risk for infection and
respiratory issues, insect and
rodent infestation.
Shelley was discouraged
to hear that Grandma is not
just waiting for that day
when she has time to clean
up, that Grandma is not just
being lazy, and that hoarding
is a mental health disorder
for which there is no cure.
I tried to comfort her by
mentioning that treatment
and intervention strategies
have been successful and
professionals may be able
to help.
Historically, hoarding was
associated with Obsessive-
compulsive disorder (OCD),
but in recent years it has
been identified as a separate
diagnosis that may co-exist
with other mental disorders
such as depression, bipolar
disorder, intellectual
disabilities, dementia, to
mention a few. (Kellum,
2012) Research into hoard-
ing by older adults is limited
and statistics are outdated,
but in 2008 it was reported
that three to five percent of
the U.S. population hoarded.
(Samuels et al., 2008) A
recent study revealed that
hoarding behavior starts
in adolescence, but that it
intensifies with age. (Ayes
GILROY • MORGAN HILL • SAN MARTIN
et al., 2010) Unfortunately,
hoarding disorder (HD) is
an equal opportunity prob-
lem—it does not discriminate
based on education, socio-
economic status, age, or sex.
One study conducted
with people with dementia
(PWD), found that 36
percent tended to have
hoarding tendencies and in
another study, 22 percent of
PWDs hoarded. (Hwang et
al., 1997) Studies conducted
in 2012 suggested that
hoarding tended to be linked
to the type of dementia
where frontal lobe functions
were compromised. Sadly,
these cases were found to
be unaddressed for years
because families were either
in denial or did not know
what to do, landlords did not
want to kick an older adult
out of their premises, etc.
In some cases, it takes a third
party to bring the issue
to light.
The bottom line is that
the hoarder you love may
need professional help!
Hoarding is more com-
plicated than it seems. It
involves medical and health
factors. In fact, gene research
suggests that HD may
also be a result of genetic
abnormality or brain injury.
(Saxena, 2007) Do some-
thing. Call his or her pri-
mary physician and start the
conversation. The physician
may know someone they can
recommend. Serotonergic
and antipsychotic medicine
(Mendez and Shapira, 2008;
Suh et al., 2006), as well as
june/july 2019
gmhtoday.com
behavioral methods (Baker at
al., 2011), may be considered
when deciding on the appro-
priate intervention.
The success of the inter-
vention, like everything else,
is different for everyone. The
support and cooperation
of the family is critical; the
treatment needed will likely
be ongoing and the need for
ongoing appropriate services
continuous. Don’t shoot the
messenger but be prepared,
it could be a tedious and
expensive process, but please,
seek help because allowing
hoarding to continue could
present bigger problems…
could be a bigger mess.
Sources:
Frost, R.O. & Hartl, T. (1996). A cognitive-
behavioral model of compulsive hoarding.
Behavioral Research and Therapy.
Hwang, J.P., Tsai, S.J., Yang, C.H., Liu, K.M.
& Lirng, J.F. (1998). Hoarding behavior in
dementia. A preliminary report, American
Journal of Geriatric Psychiatry.
Kellum, H. (2012). A Hoarding Behavior in
the Elderly. Age in Action.
Saltz, E.B. Hoarding and Elders: Current
Trends, Dilemma and Solutions. Journal of
Geriatric Care Management, 2010.
Steketee, G; Frost, Randy O., Hyo-Jim, K.
(2001). Hoarding by Elderly People. Health
and Social Work.
Written by
Dorie Sugay,
the Executive
Director of
Visiting Angels.