Hoarding disorder is when somebody collects or accumulates a large number of things, usually stored without any particular order. The person who hoards may never use many of the items in their hoard but enjoys acquiring them and has great difficulty in getting rid of them. What sort of items people hoard can vary wildly, from a collection of valuable items that has got out of control to actual waste and rubbish.
These hoards can severely affect the person’s living conditions and quality of life. Between 2 - 5% of people in the UK have hoarding behaviour, with a significant amount of these being older people.
The things that people choose to hoard are always significant to them, even if they appear worthless to others. There is a deep emotional attachment to the possessions themselves. They can be strongly connected to their sense of identity, particularly a past identity which they have difficulty letting go of, which can be more prevalent in older people. For example, a mother whose children are grown up and gone might nostalgically keep and treasure all their toys, long-outgrown clothes and artwork.
Many people collect things that they prize, like memorabilia connected to a passion they have that forms part of their identity. Quite often its in the belief that it could be worth something, or useful in some way. To determine whether a collection has become a hoard, a system called 'the Clutter Image Rating Scale' is used. This is a chart showing 9 numbered images, each with a greater degree of clutter than the last. Each room can be compared to the images to see which number image it looks the most like.
Why Do Older People Hoard?
People of all ages hoard for many emotional, physical or physocoloical reasons. In older people, dementia as well as physical and practical reasons can often cause their possessions get out of hand.
Older people may find it more physically demanding to keep on top of housework or clear an existing hoard. They often also have more possessions than they have room for through inheritance or because they have downsized their home after their children have flown the nest.
Dementia can affect a person’s abilities with planning and organising items. Also, people living with dementia can be less likely to really see their hoard; they may not be fully aware of how big it is or the dangers it could pose, such as fire hazards or risk of infestation. For older people for whom their hoarding has gone on for many years, it can be time that has caused such a large amass of belongings. If they never address the mental health or psychological reasons behind their hoarding, it simply builds up.
Support from Older Adult Mental Health Teams is a temporary measure, but many older people who require home care can have mental health support as part of their care package. Some home care services employ care workers who are trained in certain mental health areas, while many can construct your care plan in conjunction with your mental health care needs, ensuring all carers know exactly how to deliver your physical and mental health care.
The key to helping a person who hoards is to support them to address the reasons they hoard and deal with those at their own pace. Then they may be ready to clear their clutter because they are ready to do so, in their own time.
Practical steps you could take to support them include:
Learn about hoarding and try to understand why they have this behaviour.
Direct them to helplines for people with hoarding behaviour.
Encourage them to seek counselling to deal with the emotions behind their hoarding. Their doctor can refer them to counselling or an appropriate therapy.
A person who hoards can be the easiest person in the world to find gifts for, but try to avoid adding to their possessions, even though it’s in good faith.
Leave their belongings alone. It can be extremely upsetting for someone who hoards if you discard their possessions without their permission. It may seem like rubbish to you, and in many cases it is, it’s essential to respect that these are their belongings, they don't see them as rubbish. If you live together, you could instead set boundaries about which spaces must be kept clear, encourage them to get rid of a few things on a regular basis.
Many areas have hoarding support groups that help people to find other ways to manage their emotions and enable them to slowly start reducing their clutter.
Why do older people hoard?
Hoarding can be particularly prominent in older people for a variety of reasons. Older people naturally gain belongings over their lives, including through inheritance, most items will have sentimental and emotional value to them. They can also struggle physically with keeping their home clear and tidy. For those with mental health or psychological reasons behind their behaviour, symptoms may get worse over the years if it goes unaddressed.
How can hoarding be dangerous?
Hoarding will negatively impact physical and mental health. Hoards can become infested, particularly with rats, dust mites and mould. They can also hide severe trip and fire hazards. People who hoard very often have emotional attachments to their possessions and getting rid of things causes them stress and anxiety. The belongings then serve as a constant reminder of the trauma that triggered their hoarding behaviour.
How to help a hoarder
Simply clearing a hoard is not effective if the emotional reasons that the person hoards are not sorted out. Councils can order people to clear hoards, but eventually it will only build back up again. It's far more effective for the person to get support to enable them to address why they hoard and to then start to get rid of their things at their own pace. There are support groups in most areas and charity Hoarding UK has a helpline for hoarders and their loved ones.