Hoarding: What it is? - Why do they hoard? - How can families help?

Hoarding is a serious issue that can significantly impact the quality of life of older adults. It is a behavioral disorder that involves an excessive accumulation of possessions, often to the point where the individual’s living spaces become unmanageable. Older adults may be especially prone to hoarding behavior due to a variety of factors, including changes in physical and cognitive abilities, social isolation, and past traumatic experiences. In this article, we will explore the reasons why hoarding occurs in older adults and provide some guidance on how families can help their loved ones overcome this difficult issue.

What is hoarding?

Hoarding is a complex disorder that is often misunderstood. The American Psychiatric Association defines hoarding disorder as a persistent difficulty discarding or parting with possessions, regardless of their actual value. This behavior leads to the accumulation of possessions that clutter and congest living spaces, interfere with their intended use, and pose risks to health and safety.

In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), hoarding disorder is characterized as a separate and distinct disorder from obsessive-compulsive disorder (OCD), which it was previously classified under in the DSM-IV.

According to the DSM-5, hoarding disorder is defined as a persistent difficulty discarding or parting with possessions, regardless of their actual value, due to a perceived need to save them, a fear of losing them, or a strong attachment to them. The accumulation of possessions leads to clutter that interferes with the intended use of living spaces, and can cause significant distress or impairment in social, occupational, or other areas of functioning.

In order to meet the diagnostic criteria for hoarding disorder, an individual must demonstrate all of the following:

1.            Persistent difficulty discarding or parting with possessions, regardless of their actual value, due to a perceived need to save them, a fear of losing them, or a strong attachment to them.


2.            The difficulty discarding possessions results in the accumulation of clutter that interferes with the intended use of living spaces.


3.            The hoarding behavior causes clinically significant distress or impairment in social, occupational, or other areas of functioning.


4.            The hoarding behavior is not attributable to another medical condition, such as a brain injury, or to the direct effects of a substance, such as drugs or alcohol.


5.            The hoarding behavior is not better explained by the symptoms of another mental disorder, such as OCD, major depressive disorder, or schizophrenia.


The DSM-5 notes that hoarding disorder is associated with a range of negative outcomes, including social isolation, family conflict, financial problems, and health and safety risks. It also acknowledges that the disorder can be difficult to treat and often requires a multidisciplinary approach, including psychotherapy, medication, and/or behavioral interventions.

Overall, the DSM-5 characterizes hoarding disorder as a serious and distinct mental disorder that can significantly impact an individual's quality of life and requires specialized treatment and support.

Hoarding is often accompanied by an intense emotional attachment to possessions, which can make it difficult for individuals to recognize the negative impact of their behavior on their living conditions and relationships with others. Hoarding can also interfere with daily activities such as cooking, cleaning, and sleeping, and may even lead to social isolation and other mental health issues.

Why do older adults hoard?

Hoarding is a complex issue that can be caused by a variety of factors, including genetics, environment, and life experiences. While anyone can develop hoarding behavior, older adults may be especially prone to this disorder due to a variety of reasons.

One of the primary reasons why older adults hoard is that they may have experienced significant losses in their lives, such as the death of a spouse or close friend, retirement, or declining health. These losses can trigger feelings of loneliness, depression, and anxiety, which can lead to hoarding as a way to cope with these emotions.

Another factor that may contribute to hoarding in older adults is a decline in physical and cognitive abilities. As individuals age, they may experience physical limitations that make it difficult to maintain their homes and belongings. Additionally, cognitive decline may make it challenging for individuals to recognize the negative impact of their behavior and to make decisions about what possessions to keep and what to discard.

Finally, social isolation is another factor that may contribute to hoarding in older adults. As individuals age, they may become more isolated from their social networks, which can lead to feelings of loneliness and a lack of purpose. Hoarding can provide a sense of comfort and security, as well as a way to fill the void left by the absence of social connections.

How can families help?

Hoarding can be a challenging issue for families to address, as it often involves deeply ingrained emotional attachments to possessions. However, there are several strategies that families can use to help their loved ones overcome hoarding behavior and improve their quality of life.

The first step in helping an older adult who hoards is to approach the issue with compassion and understanding. It is important to recognize that hoarding is a complex issue that may be rooted in past experiences and emotions. Rather than criticizing or shaming the individual, families should try to approach the issue with empathy and a willingness to listen.

Once a family has established an open and compassionate dialogue with their loved one, they can begin to explore strategies for addressing the hoarding behavior. One effective strategy is to work with a mental health professional who specializes in hoarding disorder. A therapist can help the individual understand the root causes of their behavior and develop strategies for overcoming it.

Another strategy that can be effective is to work with a professional organizer who specializes in hoarding disorder. A professional organizer can help the individual sort through their possessions and determine which items are most important to them. They can also help the individual develop strategies for organizing and storing their belongings in a way that is safe and manageable.

In some cases, families may need to consider more extreme measures to address hoarding behavior. For example, if the individual’s living conditions are unsafe or unsanitary, it may be necessary to involve local authorities or social services to address the issue. However, it is important to approach this process with compassion and sensitivity, and to work with the individual to develop a plan that is respectful of their needs and preferences.

Finally, it is important for families to recognize that overcoming hoarding behavior is a long-term process that requires patience and persistence. It may take several months or even years for an individual to fully overcome their hoarding behavior and develop healthy habits for managing their possessions. However, with the support of their loved ones and the guidance of mental health professionals, it is possible for individuals to overcome hoarding behavior and improve their quality of life.

Conclusion

Hoarding is a serious issue that can significantly impact the quality of life of older adults. It is a complex disorder that is often rooted in past experiences, emotional attachments, and cognitive or physical limitations. However, with the support of their loved ones and the guidance of mental health professionals, it is possible for individuals to overcome hoarding behavior and improve their quality of life.

If you are concerned about a loved one who may be hoarding, it is important to approach the issue with compassion and understanding. Work with a mental health professional and a professional organizer to develop strategies for addressing the hoarding behavior and be patient and persistent as your loved one works to overcome this difficult issue. With the right support and guidance, it is possible for individuals to overcome hoarding behavior and improve their quality of life.

Hoarding Resources in DFW

• Organized + Tidy
• The Junkluggers DFW and National
• Wayforth
• The Family House Company
• Elderly Care Concierge
• Astute Back-Office
• Alzheimer's Association
• Dallas Area Agency on Aging - Older Adults
• Redfield Realty Team
• Perimeter Behavioral Hospital Dallas
• Wellbridge Healthcare
• The Senior Source

Medical Information

• Mayo Clinic Hoarding Disorders
• American Psychological Association - Treating people with hoarding disorder

Non-Profit Organizations

These non-profit organizations offer valuable resources and support for individuals and families affected by hoarding disorder, and can help connect individuals with the specialized treatment and resources they need to overcome this condition.

1.   International OCD Foundation (IOCDF): The IOCDF is a non-profit organization that is dedicated to improving the lives of individuals affected by OCD and related disorders, including hoarding disorder. They offer resources for individuals and families, including a directory of treatment providers, suInternational OCD Foundationpport groups, and online resources.


2.   Children of Hoarders (COH): COH is a non-profit organization that provides support and resources for individuals who have a parent with hoarding disorder. They offer online support groups, webinars, and educational resources to help individuals better understand and cope with their parent's hoarding behavior.


3.   Institute for Challenging Disorganization (ICD): The ICD is a non-profit organization that is dedicated to addressing the needs of individuals with chronic disorganization and hoarding behavior. They offer training and certification programs for professional organizers, as well as resources for individuals and families, including support groups, educational materials, and a directory of professional organizers.


4.   National Association of Professional Organizers (NAPO): NAPO is a non-profit organization that represents professional organizers and provides resources and support for individuals and families dealing with hoarding disorder. They offer a directory of professional organizers who specialize in hoarding behavior, as well as educational resources and support groups for individuals and families.


5.   Anxiety and Depression Association of America (ADAA): The ADAA is a non-profit organization that provides resources and support for individuals with anxiety and depressive disorders, including hoarding disorder. They offer educational resources, online support groups, and a directory of treatment providers.


Author: Kathleen Warshawsky, BSN, RN | Publisher Seniors Blue Book Greater Dallas | https://www.linkedin.com/in/kathleenwbsnrn/