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Hoarding (part 2)

Author: Helen Dennis, Specialist on Aging

Dear readers,

This week’s column is a continuation of our discussion about hoarding.  The father of M.E. is a hoarder which has created great stress for her.  The situation has gotten worse since his wife died.  She asks what to do?  Last week we discussed what “not” to do.  This week we’ll consider “what to do.”

Hoarding behavior is more prevalent than we think.  A 2008 study by Johns Hopkins University scientists estimated that nearly four per cent of the population is hoarders

Here are some suggestions written by Cristina M. Sorrentino from the Boston University School of Social Work and published by the Massachusetts Finance Agency.

  • Place yourself in the hoarder’s shoes.  How would you like others to speak to you?  How would you like them to help you manage your anger, frustration, resentment and embarrassment?
  • Match the person’s language.  If the individual refers to his or her possessions as “my things,” use the same language such as” your things.”
  • Use language that is encouraging; one that does not put the hoarder on the defensive.  Try to focus on solving the problem in a supportive way.  Sorrentino gives us an example.  “I see a pathway from your front door to your living room.  That’s great that you’ve kept things out of the way so that you don’t slip or fall.  I see that you can walk through here pretty well by turning sideways. Somebody else who might need to come into your home like a fire fighter or emergency responder would have a pretty difficult time getting through here with their equipment and bulky protective clothing.  It’s important to have a pathway that is wide enough so that they could get through to help you…The law requires it.”
  • Emphasize strengths.  Everyone has strengths.  Noticing these can help in establishing a good relationship.  One could say, “What a beautiful painting,” “I can see how easily it is to  get to your refrigerator” or I see that you are caring so well for your cat.”
  • Start with a focus on safety.  At some point, the fate of the items will be necessary.  It’s easier to start with issues of safety and organization.

The Los Angeles Department of Mental Health has additional suggestions:

  • Encourage the older adult to tell his or her story about the current situation.
  • Respect the individual’s attachment to the possessions; the feelings may be as intense as human attachment.
  • Remain calm, caring, supportive and factual.
  • Refer the individual to medical and mental professionals for an evaluation.
  • Involve the older adult in seeking solutions.

Although the urge is to just clean out the stuff, it is not recommended as the preferred approach.  Rather, what has been shown with modest success is therapy that combines regular short discarding sessions while trying to systematically restructure the way a hoarder thinks about clutter.

Setting specific goals such as clearing space to sleep in a bed or to eat at a table is useful.  Note that therapists require lots of patience.  Imagine having a 30-minute discussion about whether to keep an expired coupon.

Experts say that those with dementia and hoarding behaviors are not candidates for therapy.   Henrietta Kellum who helped found one of the country’s first hoarding task forces in Arlington, Virginia is quoted in the AARP Bulletin as finding some older people benefiting from an approach used by some retirement communities.  That is periodic inspection with a weekly cleaning service.

The problem is complex with no easy answers.  Here are resources mentioned last week.

Beach Cities Health District at (310) 374-3426, ext. 149 or South Bay Senior Services at 325-2141 for a care manager to conduct an assessment; the fire department if fire and safety hazards are apparent; the National Association of Professional Organizers at www.napo.net for professional organizers; and the Los Angeles County Self-Help Recovery Exchange at (310) 305-8878 for support group referrals.

M.E., thank you for your important question.  Hopefully by understanding some of the causes of this behavior and exploring some of the recommendations, you will be able to influence your father’s hoarding behavior.  With best wishes and success in resolving the problem.

Copyright 2011 Helen Dennis. All rights reserved.

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