Home Instead Senior Care
Louisville East & Oldham County

Roots of Compulsive Hoarding Disorder

 

According to the Anxiety and Stress Disorders Institute of Maryland (ASDI), “Hoarding is usually considered a subtype of Obsessive Compulsive Disorder (OCD). Like other compulsive behaviors, hoarding is an effort to manage the anxiety raised by obsessive doubts. There are varying levels of hoarding behavior. A diagnosis of OCD of the hoarding type is made when there is significant distress or disruption to feelings of self-worth, interpersonal relationships, education, occupation, housing, finances, legal issues, or health as a result of hoarding behavior.”

 

Research conducted by A&E channel’s real life-based intervention show “Hoarder,” indicates that over 3 million people are affected with this pathological condition. Melanie Stokes, owner of Louisville-based Intuitive Living, consulted with A&E in 2008 as they produced the first episode in this highly successful series.

 

“When someone tells me they have a collection, I ask them if it’s something they are proud of…something they want to share with others. If they say “yes,” then of course we look at their collection together,” stated Stokes, “But if they shy away from showing off something or they are ashamed to disclose the nature of their collection, then I’d say that would raise a potential ‘red flag’ that there could be an underlying issue to investigate further.”

Condition Affects Growing Number of Seniors

 

Compulsive hoarding is on the rise, increasing as our population is aging, in part due to the culture under which many of our seniors were raised coupled with the conveniences of today’s technology. According to David Dudley of AARP in an excerpt from “Conquering Clutter”, January & February 2007, “For older people the challenges of keeping clutter at bay take on a specific dimension. Depression-era mindsets about the value of manufactured goods have not adapted to the short shelf lives of today’s technology. That same technology is making it even easier, via the Web, to participate in the consumerist frenzy that is American culture.”

Dudley continues, “Meanwhile, household demands have grown in complexity as an array of vendors now deliver cable TV, Internet access, and cell phone service, and their accompanying monthly bills, to a home already lashed with a steady stream of junk mail. Add the inevitable health concerns, complicated medication schedules, and related memory issues that advancing age can bring on, and a once functional household can descend into chaos practically overnight. The dangers are both physical, a cluttered house is an obstacle course for people with limited mobility, and psychological. Particularly when the day comes that all that stuff has to go”.

Laundry room of a person with Compulsive Hoarding Disorder.

Warning Signs

 

Diane Carbo, an RN, geriatric care manager and author of articles pertaining to senior adult issues, notes that studies show that many elderly hoarders have been diagnosed with an anxiety or personality disorder.

Data shows that over 40% of people who suffer from obsessive-compulsive disorder (OCD) are known to be hoarders. Extreme cases of those with hoarding disorder will fill their homes with accumulations of junk such as newspapers, bags of old clothing and lists. These individuals tend to experience anxiety, depression and social isolation. One tool to help gauge the severity of the disorder is the NSGCD Clutter Hoarding Scale.

 

 

 

 

Characteristics of compulsive hoarding disorder:

* Related to Obsessive-Compulsive Disorder
* Difficulty throwing things away
* Compulsive buying
* Picking up free, unneeded or worthless items
* Extreme levels of disorganization and clutter
* Intensifies over time with powerful emotional attachments to stuff

Health and Safety Issues

 

One of the biggest concerns about compulsive hoarding disorder are the ways the condition affects the health and safety of the person suffering from the condition. According to a report issued by the Fairfax County Hoarding Task Force Annual Report, Fairfax, VA, Mar. 2009, compulsive hoarding creates undesirable circumstances such as:

 

* Dangerous living conditions compromising well-being
* Clutter overtakes sleeping, eating and hygiene, decreasing the quality of life
* Accumulation of combustible material, trash, food, and/or animals create serious personal safety, fire and health hazards and can cause disease, vermin or insect infestation
* In many cases clutter blocks or seriously obstructs doorways, windows, exit paths which limit escape during an emergency by the occupant as well as hindering the ability of public safety personal to get inside
* Hoarding cases almost always involve structural overload conditions leading to severe overstressing of structural members such as joists and beams.

Treatment

Laundry room after eliminating clutter and organizing the area.

 

While compulsive hoarders are less likely to seek professional help than those with any other mental health disorder, approaches to treatment may include:

 

* Collaborative therapy, which is a process that expands beyond the patient-therapist relationship to include professional organizers, coaches and social services to help process the connection between the emotional conflicts with physical things. A compassionate, professional approach must be developed in order to provide the opportunity for change.
* Medication can help alleviate the symptoms of conditions that may exacerbate hoarding, such as depression. However, medication alone does not appear to help reduce the symptoms of compulsive hoarding.

Resources
National Study Group on Chronic Disorganization
Obsessive Compulsive Foundation
Anxiety and Stress Disorders Institute of Maryland
National Association of Professional Organizers

Hoarding: A Self-Evaluation*

 

As a quick exercise, answer all five questions below scoring each response with a ranking from 1 to 5. One (1) represents a response where there is no issue of hoarding to five (5) representing a response that may indicate a potential problem:
1. Do you have difficulty letting go of a large number of personal possessions?
2. Do you have an excessive collection of newspaper, magazine, clothing, household trash & animals?
3. Does your clutter interfere with your day-to-day activities?
4. Do you have cluttered pathways that make it cumbersome to get from room to room?
5. Do you experience intense anxiety or distress attempting to discard or even thinking about discarding what most people view as useless?

Now add your scores together for all five questions, divide by five to arrive at your total score. Please refer to the key below.

Scoring:

5 - Don’t panic, but it’s possible you may wish to speak to a professional to learn more about compulsive hoarding disorder.
4 - Check the hoarding scale for additional details on degrees of hoarding.
3 - Start with one room or area at a time to begin to de-clutter your environment.
2 - It might be helpful for you to set a few priorities.
1 - All’s fine with your perspective on your “stuff”.

 

NOTE: This self-evaluation is intended for general informational purposes only. Neither Home Instead Senior Care or Intuitive Living make any claims of providing a diagnosis, which should only be rendered by your medical or mental health professional.
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Melanis Stokes of Louisville-based Intuitive Living contributed her expertise for this posting.

Home Instead Senior Care of East Louisville and Oldham County collaborated on this article with Melanie Stokes, a professional organizer and member of the National Association of Professional Organizers (NAPO) who specializes in organizing solutions. Her clients at Intuitive Living include private individuals and corporations. She often presents educational programs on organizing and creating stress-free environments to associations and organizations. Melanie has been featured as an organizing expert in a number of Louisville publications including the Courier Journal, Today’s Woman and Business First. She has provided her expertise to large local television audiences through shows on WAVE 3, WHAS 11, WLKY 32 and Fox 41.