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Hoarding and the Elderly

HOARDING AND THE ELDERLY Hoarding is a growing problem today among all populations, including the elderly. A recent study showed that more than 40 percent of hoarding complaints to the local health departments involved senior services agencies, and other studies have found that hoarders are significantly older than non-hoarders. It is important for caregivers to recognize the signs and symptoms of this disorder and to get the appropriate treatment for their loved one. Hoarding is the excessive collection of items and the inability to discard them. The thought of getting rid of their belongings creates high levels of anxiety. Hoarding has been thought to be a sub-type of obsessive-compulsive disorder, but this theory is now under review. The homes of hoarders are filled to capacity with things that are of no use to the person collecting them. The person may hoard things that they feel have emotional significance, serving as a reminder of happier times. They also report feeling safer when surrounded by the things they collect. Hoarding often leaves the home in an unsanitary condition and so cramped that every day tasks of daily living such as bathing and cooking are no longer possible. It can also cause social isolation, as the hoarder avoids inviting friends and family members into the home to visit. Signs and symptoms of hoarding include the following: • Cluttered living spaces • Inability to discard items • Stacked newspapers, magazines or junk mail • Moving items from one pile to another, without discarding anything • Acquiring unneeded or seemingly useless items, such as trash • Difficulty managing daily activities, including procrastination and trouble making decisions • Difficulty organizing items • Perfectionism • Excessive attachment to possessions, and discomfort letting others touch or borrow possessions • Limited or no social interactions Hoarding can affect anyone regardless of age, sex or economic status. A recent study done with elderly hoarders uncovered that most elderly hoarders were female, unmarried, and lived alone. Those who had never been married had more severe hoarding characteristics and greater impairment, and treatment for these individuals was much more challenging. Risk factors that researchers have found include the following: • Age: Hoarding usually starts at an early age and gets worse as people age. • Family History: People have more of a tendency to hoard if someone in their family has this disorder. • Stressful Life Events: Stressful events such as divorce, losing a loved one, eviction or losing possessions in a fire can trigger hoarding. • Social isolation: Hoarding can lead to social isolation, but hoarding can also be a comfort to people who are isolated and lonely • Perfectionism: People who are afraid to make a mistake, and thus avoid making decisions have a tendency to hoard If you have a loved one that exhibits some of the characteristics above and you suspect that hoarding is an issue, it is important to approach the person in a way that is nonthreatening. Attempts by family members to tidy up the living space of compulsive hoarders by throwing out the clutter will alienate the patient and increase resistance and isolation. The hoarder has a high level of anxiety at the thought of throwing out belongings. Actually taking this action elevates the anxiety level even further. A cornerstone in dealing with this disorder is that the hoarder be the only person who discards his possessions. It is also important to seek the advice of a professional who is trained in dealing with this disorder. Treating hoarding can be very challenging. The biggest hurdle in treatment is that people who hoard do not often see the negative impact this is having on their lives. So, they do not think they need treatment nor do they seek it out. The two primary treatments for hoarding are psychotherapy and medication. Researchers continue to try these interventions and research continues to find the best possible solutions for people afflicted with this disorder.
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