Hoarding
Some people will hoard or save numerous items, including dirty clothes, food, and papers. Losing a meaningful role in life, work, friends, family, and a good memory can have an impact on a person’s need to hoard and or to “keep things safe”. Hoarding in this population is oftentimes triggered by the fear of being robbed.
When working with persons who have dementia, it is essential that you keep their safety in mind. Order, routine and simplicity are most helpful. A house or room that is relatively uncluttered is the ideal environment.
Ten Tips to Consider
1. Let go of ideal notions of cleanliness. Your patient may value items that appear to you as worthless. Parting with their belongings (even used paper cups) can cause severe emotional distress.
2. Ask your patient if they can donate or sell their belongings to charity.
3. Focus on fall prevention. Create pathways free of debris, loose cords or slippery rugs. Some frail patients hold onto furniture or other items while moving through the room; preserve their “props” until other assistive devices (canes, walkers) can be introduced.
4. Focus on fire prevention. Red flags include newspapers stored on top of or inside a hazardous area.
5. Be creative and negotiate. Consider photographing belongings, as this may help the patient part with things and preserve memories.
6. Begin by reorganizing a small corner of a room, a single table, or just a section of the table.
7. Have a friend or relative present during a major cleanout, preferably one who already has a supportive relationship with the patient. Clean-outs can be overwhelming to people with severe hoarding behavior. Have a back-up plan in case emergency psychiatric services are needed.
8. Discuss how to safeguard valuables in the cleaning process. Have a written contract. Agree on what to do with valuables that turn up, such as money, jewelry, or collectibles.
9. Consider relocating an individual to a new room if the clutter is the result of physical or mental frailty. A new environment can provide a fresh start and enable the patient to receive needed services sooner.
10. Plan for on-going maintenance and supervision to maintain a decluttered environment.
Adapted From: Weill Medical College of Cornell University
