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 individuals 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 individuals 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.ConclusionHoarding 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 DFWOrganized + TidyThe Junkluggers DFW and NationalWayforthThe Family House CompanyElderly Care ConciergeAstute Back-OfficeAlzheimer's AssociationDallas Area Agency on Aging - Older AdultsRedfield Realty TeamPerimeter Behavioral Hospital DallasWellbridge HealthcareThe Senior SourceMedical InformationMayo Clinic Hoarding DisordersAmerican Psychological Association - Treating people with hoarding disorderNon-Profit OrganizationsThese 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/

The Success of Aducanumab in Treating Alzheimer's DiseaseAducanumab is a medication that has received a lot of attention in recent years for its potential in treating Alzheimer's disease. Alzheimer's is a progressive neurological disorder that affects memory, thinking, and behavior, and there is currently no cure for the condition. Aducanumab is a type of drug called a monoclonal antibody, which works by targeting and removing sticky deposits of a protein called beta-amyloid that build up in the brains of individuals with Alzheimer's.Aducanumab has shown promising results in treating Alzheimer's disease. It is a monoclonal antibody that targets beta-amyloid, a protein that accumulates in the brain and is associated with the development of Alzheimer's. The drug works by removing beta-amyloid from the brain, slowing the progression of the disease and potentially improving cognitive function.In clinical trials, Aducanumab has been shown to reduce beta-amyloid levels in the brain and slow cognitive decline in patients with early Alzheimer's disease. The results of these trials have been highly promising and have led to the approval of Aducanumab by regulatory agencies in several countries.One of the most significant findings of the clinical trials was the observation of a statistically significant reduction in clinical decline in patients who received Aducanumab. This reduction in decline was observed in measures of cognitive function, such as memory and thinking skills, as well as in measures of daily functioning, such as the ability to perform basic activities of daily living.Another important finding from the trials was the observation of a favorable safety profile for Aducanumab. The majority of patients who received the medication did not experience significant side effects, and those that did were generally mild and manageable.In November 2021, the United States Food and Drug Administration (FDA) granted accelerated approval for Aducanumab as a treatment for Alzheimer's disease. This decision was based on evidence from clinical trials, as well as on the need for new treatments for Alzheimer's, which is a growing global health crisis. The FDA has required the manufacturer of Aducanumab, Biogen, to conduct additional studies to confirm the drug's benefits and to better understand its risks and side effects.The development of Aducanumab has been the subject of numerous clinical trials, with positive results seen in early trials in reducing beta-amyloid deposits in the brains of individuals with Alzheimer's. It is important to note however, that more recent trials have produced mixed results, with some studies showing a slowing of cognitive decline in individuals taking Aducanumab and others showing little to no effect.Aducanumab is a promising new treatment option for Alzheimer's, although more research is needed to determine its long-term safety and effectiveness. Individuals and their families should discuss with their healthcare provider the potential benefits and risks of taking Aducanumab, as well as other treatment options that may be available.In conclusion, Aducanumab is a medication that has received attention for its potential in treating Alzheimer's disease. The drug works by targeting and removing beta-amyloid deposits in the brain, which is believed to contribute to the progression of the disease. While the results of clinical trials have been mixed, the FDA has granted accelerated approval for Aducanumab as a treatment for Alzheimer's, with additional studies required to confirm its benefits and risks. Individuals and their families should consult with their healthcare provider to determine if Aducanumab is the right treatment option for them.References:      Alzheimer's Association. (2021). Aducanumab.      Biogen. (2021). Aducanumab.      FDA. (2021). Aducanumab Approval Letter.      National Institute on Aging. (2021). Alzheimer's Disease and Dementia. Author: Kathleen Warshawsky, BSN, RN | Publisher Seniors Blue Book Greater Dallas | https://www.linkedin.com/in/kathleenwbsnrn/Other articles you may like:Aducanumab and Lecanemab: How are they different?The Success of Lecanumab (Leqembi) in Treating Alzheimer's DiseaseThe Success of Aducanumab in Treating Alzheimer's Disease

Dementia: Improving Communication with Improv | Mirroring Technique is part of a six-part series. Dementia is a degenerative neurological condition that affects millions of people worldwide. As the disease progresses, individuals with dementia may experience difficulties with communication, including problems with memory, language, and understanding. This can make it challenging for caregivers and family members to connect with their loved ones and provide the best possible care. However, there is a promising solution to this challenge: improv. In this six-part series, we will explore how improvisational theater techniques can be used to improve communication and connection with individuals with dementia. By tapping into the power of improv, caregivers can learn how to communicate more effectively, build rapport, and create meaningful experiences with their loved ones.Dementia is a debilitating condition that affects millions of people around the world. It is a progressive disease that affects memory, thinking, behavior, and the ability to perform daily tasks. As the disease progresses, individuals with dementia may have trouble communicating and may become withdrawn and isolated. However, with the right approach and support, individuals with dementia can still achieve good quality of life.One approach to supporting individuals with dementia is to meet them where they are at. This means that care providers should strive to understand the individual's unique perspective, experiences, and needs. This approach can help to reduce frustration, confusion, and anxiety and promote a sense of well-being and connectedness.To meet individuals with dementia where they are at, care providers can use a range of strategies. One of these strategies is the Mirroring technique. Learning the Mirroring technique can ultimately improve the quality of life for individuals with dementia and their caregivers.Mirroring techniqueThe mirroring technique is an improvisation technique that involves reflecting the body language, facial expressions, and verbal communication of another person to build rapport and establish a connection. The goal is to create a safe and comfortable space for communication by demonstrating empathy and understanding.When using the mirroring technique, the caregiver or healthcare provider closely observes the person with dementia and mirrors their movements, posture, facial expressions, and vocal patterns. This technique can help the person with dementia feel validated and understood, even if they are unable to express themselves verbally.The mirroring technique involves the following steps:Observe the person with dementia: Watch the person carefully, paying attention to their movements, facial expressions, and vocal patterns. Take note of any gestures or expressions that seem to communicate an emotion or a need.Mirror the person's body language: Mirror the person's movements, posture, and gestures. For example, if the person is leaning forward, the caregiver may lean forward as well. If the person is using hand gestures, the caregiver may use similar gestures.Mirror the person's facial expressions: Mirror the person's facial expressions, such as smiling, frowning, or raising eyebrows. This can help the person feel understood and validated.Mirror the person's vocal patterns: Mirror the person's tone of voice, volume, and pacing. This can help the person feel that they are being heard and understood.Gradually introduce communication: Once a connection has been established through mirroring, the caregiver or healthcare provider can gradually introduce communication, such as asking questions or making statements that reflect the person's emotions or needs.By using the mirroring technique, caregivers and healthcare providers can establish a connection with the person with dementia, creating a safe and comfortable space for communication and building trust. This technique can help improve communication and reduce feelings of frustration or anxiety for the person with dementia.Teaching The Mirroring TechniqueTeaching someone to use the mirroring technique can be a helpful way to improve communication with someone with dementia. Here are some steps you can follow to teach someone how to use the mirroring technique:Explain the concept: Start by explaining what the mirroring technique is and how it can be used in communication. Explain that the goal is to repeat what the other person is saying, using the same tone of voice and body language. Emphasize that this can help the other person to feel heard and understood.Model the technique: Demonstrate the technique by having a conversation with the person and using the mirroring technique. Start by saying something and then repeat what the other person says, using the same tone of voice and body language. For example, if the person says, "I'm feeling confused," you might respond, "You're feeling confused." Make sure to emphasize the importance of using the same tone of voice and body language.Practice the technique: Give the person the opportunity to practice the technique. Start by having them say something and then repeat what they say, using the same tone of voice and body language. Encourage them to focus on the other person's words and emotions and to reflect those back to them.Provide feedback: As the person practices the technique, provide feedback and encouragement. Help them to identify areas where they can improve and emphasize the importance of using the same tone of voice and body language.Reinforce the technique: Encourage the person to use the mirroring technique in their daily communication. Reinforce the technique by reminding them to repeat what the other person says, using the same tone of voice and body language.Example of how the mirroring technique can be used with someone with advanced dementia:Imagine a caregiver is visiting a person with advanced dementia in a care facility. The person with dementia is sitting in a chair, looking down and not engaging with the caregiver. The caregiver wants to try the mirroring technique to build rapport and help the person feel more comfortable.The caregiver approaches the person and sits down in a chair across from them. The caregiver notices that the person is frowning, so they mirror this facial expression by furrowing their own brow. The caregiver then slowly begins to shift their facial expression to a more neutral one, and they notice that the person with dementia begins to relax their own facial expression as well.The caregiver continues to mirror the person's body language and facial expressions as they interact. When the person leans back in their chair, the caregiver does the same. When the person leans forward, the caregiver follows suit. As they continue to mirror each other, the person with dementia begins to make eye contact with the caregiver and smile.The caregiver then uses this positive engagement to begin a conversation with the person, asking open-ended questions and using the "yes, and" technique to build on their responses. Using the mirroring technique, the caregiver was able to build rapport and create a positive and engaging environment for the person with advanced dementia.Using the mirroring improv technique in caregiving can greatly enhance the caregiver's relationship with their loved one with dementia. By accepting and validating the individual's experience, caregivers can build trust, improve communication, and increase their loved one's sense of safety and comfort. Improv also allows for creative problem-solving and flexibility, which can be crucial in adapting to the individual's changing needs and abilities. Ultimately, incorporating improv as a form of communication can lead to a more positive, meaningful, and fulfilling relationship between the caregiver and their loved one with dementia.Read all of the articles in this six-part series on Dementia: Improving Communication with Improv Dementia: Improving Communication with Improv | OverviewDementia: Improving Communication with Improv | "Yes and..." TechniqueDementia: Improving Communication with Improv | Mirroring TechniqueDementia: Improving Communication with Improv | Storytelling TechniqueDementia: Improving Communication with Improv | Role-playing TechniqueDementia: Improving Communication with Improv | Musical Improvisation techniqueAuthor: Kathleen Warshawsky, BSN, RN | Publisher Seniors Blue Book Greater Dallas | https://www.linkedin.com/in/kathleenwbsnrn/References:Alzheimer's Association. (2021). Communication and Alzheimer's. 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BMJ (Clinical research ed.), 350, h369.Raglio, A., Bellelli, G., Traficante, D., Gianotti, M., Ubezio, M. C., Villani, D., ... & Stramba-Badiale, M. (2015). Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Disease and Associated Disorders, 29(2), 158-163.Raglio, A., Gianotti, M., Manzoni, V., Bolis, S., Ubezio, M. C., Villani, D., & Stramba-Badiale, M. (2016). Effects of improvisational music therapy vs enhanced standard care on symptom severity among patients with Alzheimer disease: The IMT-ALZ randomized clinical trial. JAMA Neurology, 73(7), 797-805.Van't Leven, N., Prick, A. E., Groenewoud, J. G., Roelofs, P. D., de Lange, J., Pot, A. M., & Van't Leven, N. (2013). Communication enhancement between dementia care professionals and dementia patients during daily care. Aging & Mental Health, 17(5), 555-568.