THE SITUATION

When you visited Mom or Grandpa recently the signs were everywhere. The hallways and staircases were covered with old newspapers, the fridge contained sour milk and spoiled produce, and the clutter was taking over the house. Hoarding involves the excessive accumulation of items and an inability to get rid of them. Individuals may hide things, like food or money, because they feel a need to “hold onto” or “complete” something, or may store familiar objects to preserve memories or feel safe. This behavior can appear or intensify due to symptoms of Alzheimer’s disease, including memory loss, confusion, lack of judgment, and inability to make decisions and do sequential tasks. The person may forget that they’ve bought certain products and keeps re-buying them, may not remember to throw used items away, and may lack the ability to organize or distinguish between important items and trash. In addition, paranoia and delusions, which often result from the brain disorder, could prompt someone to hide things so they are not stolen. If left unresolved, hoarding behavior can often become problematic and dangerous for the individual with Alzheimer’s disease and other members of the household.

THE SOLUTION

  • Hold a family meeting. Discuss concerns to determine next steps.
  • Visit frequently to assess whether the person can continue to live alone. Is the clutter a threat to the person with the disease and even to neighbors? Is it affecting the person’s self-care, such as eating and bathing?
  • Look for unsafe and unsanitary conditions. For example, piles can increase the risk of falls and fires, and dust, mold and pests can cause respiratory illnesses.
  • Clear out the mess slowly. This may help ease a person’s anxiety and emotional distress.
  • Involve people in the early stages of Alzheimer’s disease. If judgment is not impaired, a person with dementia may be able to assist on a “good day,” thus retaining a sense of control. Divide clutter into “keep it,” “toss it” or “think about it” piles. Work one-on-one, offer simple, step-by-step instructions and minimize distractions.
  • Seize control in the later stages of the disease. When symptoms prevent someone from modifying behavior or helping to clean up, take action if hoarding poses a clear danger. Organize, throw out and concentrate on maintenance. Coordinate caregiving so the work does not occur while the person is at home.
  • Learn hiding places. Common locations include inside wastebaskets, closets and pocketbooks, and under cushions and beds.
  • Check the refrigerator, freezer and pantries frequently. Toss out items that are expired or rotten or have a foul odor to prevent the intake of spoiled or poisonous foods. Loss of taste and smell caused by Alzheimer’s disease may worsen this stockpiling.
  • Check for fire hazards. Discard excess near or in radiators, fireplaces, stoves, etc. that could cause a fire. Make sure pathways and exit doors are clear, and smoke alarms work.
  • Reduce the amount of mail. If mail poses a problem, have it delivered to an alternate location such as a post office box or friend’s home. Work with the person with dementia to process any incoming mail and pay bills, or take over if the person is incapable. For unwanted mail—catalogues, solicitations, etc.—join the “national do not mail list” (www.directmail.com).
  • Keep tabs on trash. Check garbage cans for hidden items, and dispose of trash immediately from the property
  • Call in experts, if necessary. Many areas have community task forces to coordinate care on this issue. Also try public health agencies, elder service providers and professional organizers.
  • Discuss potential medical treatments. There is no clear-cut medical treatment for hoarding, although sometimes a doctor may prescribe anti-anxiety medication to help with this behavior.
    – WRITTEN BY JESSIE McHEFFEY

PREPARE IN ADVANCE

Keep duplicates of important items, if possible. This includes hearing aids, medications, dentures and other items related to activities of daily living. Put away valuables. This way, you avoid crisis mode if they get lost amidst the clutter.