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Living With Alzheimer's >> Day-To-Day Issues | 04.24.15

Hoarding: when clutter becomes a problem

If your mother’s once immaculate home is suddenly cluttered with piles of old newspapers and magazines, the refrigerator is stuffed with food far past its prime, or kitchen drawers are jammed with used paper plates and cups, you may be witnessing the beginning of hoarding behavior. In the early and middle stages of Alzheimer’s disease and other dementias, hoarding sometimes occurs, causing problems for both the hoarder and caregiver.

Why is this happening?

Hoarding behavior can be a response to the anxiety of memory loss. The hoarded items may provide a sense of security and control at a time when it seems that very little in life is under control. A full refrigerator is security against going hungry. Overflowing closets and drawers are a reminder of a time when a person could dress and care for themselves. When so much is being taken, retrieving items from the garbage and hiding them away is a defensive measure. Many times, the person affected was a collector in their younger years and the dementia triggers an extreme version of a harmless hobby as a way to deal with the stresses of their condition.

Sometimes, confusion can be the source of hoarding. If you can’t remember what a paper plate is for, then putting it away in your dresser drawer is a reasonable response. If you can’t remember why you’re taking your medications, the stockpile in the silverware drawer avoids embarrassing questions. The loss of sequential tasking abilities makes sorting through the mail and separating bills from junk mail impossible. So it piles up. And up. And up.

Often hoarding is harmless, if somewhat annoying, but it can be a problem if the person starts to collect things that don’t belong to them. Perhaps an item reminds them of something from their past, and they want to hold onto it for comfort, even though the silver mirror belongs to their room mate. If the person is suffering from paranoia, they may even claim that others are stealing the items that they themselves have hidden away.

Why should you respond?

Yelling and harsh language won’t help; in fact, it can increase anxiety. Remember that this is a reaction to a disease the person cannot control. If the person is still able to respond to reason, talking about why they don’t need to keep the used tissues, or empty disposable coffee cups may allow them to let go of that particular collection.

Sometimes hoarding behavior can be curtailed by doing something engaging and interesting. Simple jigsaw puzzles, looking through scrapbooks, even cleaning out the pantry together can help. Folding laundry can be surprisingly engaging.

Know the hiding places

Periodically, do a sweep of the various places in the home where stockpiles turn up. The back of the closet, dresser drawers, under beds or couch cushions, in jacket pockets, even the freezer or bread drawer are prime hiding spaces where you can look if something has gone missing. Don’t forget to check the trash can before you throw it out.

Cleaning up

In an extreme case of hoarding, it’s often better to try reorganizing rather than to clean things out all at once. Clear paths to the kitchen, bath and bedroom, remove rotted food and trash. Make it safe, and work slowly to reduce the clutter by throwing things out bit by bit.

If you do throw “collections” away be sure to take the garbage bag with you, out of their reach, or they may go through it and take it all back, undoing all of your efforts.

Protect valuable or essential items

Lock away valuables, jewels, wallets or anything else that you don’t want lost. You may even go so far as to lock up certain areas of the house to keep your loved one from entering. Keep your own collectables safe. And don’t forget to check the trash can.

The lock box

Creating a permanent place for collections or special items can be helpful. Pick out a box, and decorate it—together, if you like. Put it out in plain view so that it’s easy to find. This becomes the repository for all the special things that the person likes to collect, or the items they find and don’t know what to do with. Eyeglasses, wallets, keys, etc. can also go in here. If they’re searching for something, you can tell them to “check the box”. Be sure to check the box yourself periodically to put items back where they belong.

Talk to your doctor

If you believe the hoarding behavior is extreme, consult your physician. Anti-anxiety and anti-depressive medications can sometimes help the problem.

Remember, your loved one isn’t doing this to annoy you. Rather, they are dealing with their disease the only way they can. If filling the freezer with empty McDonald’s coffee cups is what helps bring about a sense of comfort or security, that’s a small price to pay.

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