Mental Illness and the Elderly: A Primer on Hoarding

By Leah Felderman  

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Pile of junk stored in the garage

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What is the difference between collecting and hoarding? When do these statuses become more than a passive observance and require active intervention?

It is generally agreed upon that somebody's lifestyle choices are not ours to critique. But let's face it-we do judge. Try as we might not to be in a glass house throwing stones, we can't help but to compare. This is especially true when it comes to entering the homes of others. We should be gracious as somebody opens up their personal space to us and welcomes us into the most intimate part of their life. Homes vary so greatly: the home that is antiseptically clean; the home that is blissful chaos, overflowing with kids and/or pets and all the accoutrements associated with its inhabitants; the home that is now an empty nest but still retains affectionate traces of its former occupants. And then there are "those" homes: the ones that become a topic of conversation at dinner and hushed whispers of concern among neighbors. The homes that serve as a reminder to adult children to visit parents and other elderly loved ones very soon, just to check and make certain...

One man's trash is another's treasure, one man's meat is another man's poison. When do we address the state of somebody else's abode and the contents within? There are the sensationalized cable shows about hoarding, commercials advertising a "Got Junk?" business offering clean up and haul away, and an occasional heartbreaking story about an extreme hoarding situation that was so dire it made the news. Despite all the social interest in hoarding it affects a very small percentage of people: 5% of the population is the average across most sources of research. Hoarding is not directly related to age, gender, race, nationality, intelligence level, or economic status: it can affect anybody. However, hoarding does seem to disproportionately affect the elderly, therefore becoming a point of interest and concern in the aging community. How do communities, families, and loved ones recognize and address hoarding before it becomes too extreme?

Collecting or Hoarding?

The difference between collecting and hoarding may seem like a fine blurred line, a gray area, or a matter of opinion: it is not. Hoarding is very clearly a disorder. Sometimes it is a disorder in and of itself, often it is a symptom of a separate disorder. Hoarding is a mental health concern, yet also has serious implication on the physical health and safety of the hoarder, as well as to those around them.

Collecting is a hobby, a very distinct activity (and in extreme cases lifestyle) that can be rationalized, legitimized, and (ultimately) controlled. It is generally agreed upon that collectors, no matter how extreme or kitsch their interests may seem, take pride in their acquisitions. They are proud to show them off to friends, family, and even like-minded strangers. Collectors keep their acquisitions maintained, organized, and are still able to live a functional life outside of their belongings.

With hoarding, the acquisition of belongings has expanded beyond the boundaries of what is rational. Most hoarding typically has no clear and distinct goal of acquisition. There may be loose ideas such as having an affinity for reading materials, doomsday preparation, or retention of memories as represented by objects. Perhaps prior to the onset of hoarding the person was an avid Elvis memorabilia collector. In cases of hoarding, items are not maintained or able to be rationally organized. There is rarely a sense of pride in their belongings or upkeep although there is a clear need, compulsion, and desire for their acquisition. The sense of pride for a collector denigrates to shame and/or embarrassment for the hoarder. Visitors often become increasingly unwelcome as the hoarding progresses. This is usually due in part to peoples' reactions to the emergence of and backslide into hoarding. Unfortunately, the knee jerk reactions to the overwhelming chaos of a hoarding situation can lead to harsh words, unintended insults, and further isolation of the hoarder.

Hoarding is a recognized disorder, and there is help.

Make no mistake, there is a very clear distinction between an extreme case of collecting and a person that is suffering from a mental illness that causes them to hoard. Obsessive-compulsive disorders and depression are often the root mental illness with hoarding as a symptom. Increasingly, hoarding is recognized as a mental illness in and of itself. Sometimes there is a distinguishable cause or event that can be pinpointed as the incipient moment that hoarding began. Just as often it is a series of unfortunate events that slowly germinates acquisition into hoarding. There are also extreme cases deserving of mention. Sygollomania is literally the collection of rubbish (and not in the "one man's trash is another's treasure" distinction) and Diogenes' Syndrome which is hoarding in conjunction with squalor and extreme self-neglect. Regardless of its diagnosis and/or genesis, it is important to remember that hoarding is it is not a willing, cogent act of self-destruction. Hoarding is difficult to deal with, for all parties involved, as is the case with mental illness. And while there is no quick fix, no solution as easy as hauling away a dumpster full of excess acquisitions, there are places to seek help.

4 key places to seek help if you think your loved one needs help with hoarding.

Mental Health Services:

Private or public, mental health professionals are a great first stop on the road to recovery. If you are fortunate to have the financial resources and a willing elderly loved one, seeking assistance through a private counselor is a wonderful introduction to assistance. Mental health counselors are also available through your local health department.

Local Department of Health and Human Services:

Most local health departments are equipped with a department and staff that focus specifically on the elderly and disabled. They are responsible for investigating requests for help and case management of those that require assistance, either as willing or involuntary participants.

Local Hoarding Task Force:

Yes, this does exist! This is a little-known resource available in many major metropolitan areas. It is often comprised of representatives from a variety of agencies including: First Responders, Health Department, Elder Affairs, Department of Housing, and Community Interests. These representatives are well educated on the aspects of hoarding and are well-equipped to offer multi-agency support to assist the hoarder, their family, and the community.

Local Crisis Center:

Sometimes, unfortunately, you have to call in immediate reinforcements. If your elderly loved one is at serious risk of harm call 911. First Responders will come and assist and then contact the appropriate agencies for additional support. This is not the preferred model of assistance but is sometimes the only option.

Leah Felderman BA MA
 

About the Author

Leah is a proud alumnus of University of Central Florida (BA) and San Diego State University (MA). She has worn many occupational hats including teaching, hospitality management, government contractor and non-profit organizer. She is an intrepid international traveler having visited over 60 countries before happily settling down into her new life chapter of domesticity as a mom and Coast Guard wife.



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